Risk factors for the ineffectiveness of assisted reproductive technology programs after a woman’s illness with COVID-19

Abstract

Purpose - to determine the risk factors for the ineffectiveness of ART programs after a woman’s illness with COVID-19.

Materials and methods. In the group of 80 examined patients with symptoms of “long-COVID” who applied to the reproductive technology clinic for infertility treatment, 2 subgroups were distinguished: the Subgroup 1: 64 patients in whom assisted reproductive technologies (ART) was unsuccessful (cancellation of transfer, non-occurrence of pregnancy or its loss) and the Subgroup 2: 16 women with successful ART (live birth).

Results. Significant differences were found among patients with unsuccessful use of ART in terms of the frequency of the main symptoms of “long-COVID”, the following symptoms stand out: “depression, anxiety” (54.7% vs. 18.8%, p<0.05) and “sleep disturbances” (59.4% vs. 31.3%, p<0.05).

A significant difference was also found in social and household factors: the presence of stress (35.9% vs. 12.5%, p<0.05), especially in everyday life (31.3% vs. 6.3%, p<0.05), the presence of bad habits (21.9% vs. 6.3%, p<0.05).

A significantly higher frequency of decreased ovarian reserve (32.8% vs. 12.5%, p<0.05) and corresponding hormonal disorders: increased follicle-stimulating hormone (21.9% vs. 6.3%, p<0.05) and decreased anti-Müllerian hormone (25.0% vs. 6.3%, p<0.05).

Among somatic pathology, endocrine pathology stands out (45.3% vs. 12.5%, p<0.05), in particular metabolic disorders (34.4% vs. 12.5%, p<0.05). A significant difference was also established in the frequency of liver diseases (21.9% vs. 6.3%, p<0.05) and gastrointestinal tract (23.4% vs. 12.5%, p<0.05).

There is a higher frequency of menstrual disorders, namely a decrease in the duration of menstruation (20.3% vs. 6.3%) or, conversely, prolonged menstruation (17.2% vs. 6.3%), an irregular cycle (25.0% vs. 6.3%, p<0.05) and luteal phase insufficiency (21.9% vs. 6.3%, p<0.05). Urogenital infections were noted in 43.8% of patients (vs. 12.5%, p<0.05).

Conclusions. Risk factors for the ineffectiveness of ART programs have been established, among which stress, depression and anxiety, bad habits, endocrine pathology, metabolic disorders, liver pathology, menstrual cycle disorders, and urogenital infections are especially highlighted.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research.

No conflict of interests was declared by the authors.