İNFERTİL HASTALARIN COVID-19 AŞISINA UYUMU VE IVF TEDAVİ SONUÇLARI

Year 2022, Volume: 31 Issue: 3, 405 - 409, 26.12.2022

Ahmet Emin Mutlu , Didem Kaya

https://doi.org/10.34108/eujhs.1121522

Abstract

Bu çalışmanın amacı, infertil hastaların Koronavirüs hastalığı-2019 (COVID-19) aşısına bakış açılarını değerlendirmek; uygulanan COVID-19 aşısının kadınların over rezerv testleri üzerine ve in vitro fertilizasyon (IVF) tedavi sonuçlarına etkisini ölçmektir. Prospektif olarak planlanan bu çalışma Hüma Kadın Hastalıkları ve Doğum Hastanesi, Tüp Bebek Ünitesi’nde yapılmıştır. Çalışmaya Nisan 2022-Haziran 2022 tarihleri arasında infertilite nedeniyle başvuran 187 hasta dahil edilmiştir. Hastalar COVID-19 aşısı yaptırıp yaptırmama durumuna göre 2 gruba ayrıldı. Aşı yaptırmayı kabul eden 1. gruptaki 94 hastanın aşı öncesi Folikül Stimülan Hormon (FSH), Estradiol (E2), Anti Müllerian Hormon (AMH) değerlerine ve toplam antral follikül sayılarına (AFS) bakıldı. Aşı yaptırmayı kabul etmeyen 93 hastanın da aynı parametrelerine bakıldı. Aşı yaptıran ve yaptırmayan bu iki grup arasındaki over rezerv testleri ile IVF tedavi sonuçları karşılaştırıldı. Aşı yaptıran hastaların aşı öncesi ve sonrası over rezerv testleri değerlendirildiğinde FSH, AMH, E2 ve AFS bakımından istatistiksel olarak anlamlı bir farklılık bulunamadı. IVF tedavi sürecinde aşı yaptıran grup ile yaptırmayan grup arasında toplanan oosit sayısı, M2 oosit sayısı, fertilizasyon, implantasyon ve klinik gebelik oranlarında anlamlı istatistiksel bir farklılık izlenmedi (p>0.05). COVID-19 aşısı kişileri enfeksiyondan korurken over rezervi üzerinde herhangi bir azalma yapmadığı çalışmamızda gösterilmiştir. İnfertil hastalarda IVF tedavisi öncesi aşı yaptırmanın, tedavi sürecini ve sonuçlarını olumsuz etkilemediği yine bu çalışmada kanıtlanmıştır.

Keywords

AMH, COVID-19 aşısı, infertilite, IVF sonuçları, over rezerv testi

ADAPTATION OF INFERTIL PATIENTS TO THE COVID-19 VACCINE AND IVF TREATMENT RESULTS

Abstract

The aim of this study is to evaluate the perspectives of infertile patients on the Coronavirus disease-2019 (COVID-19) vaccine and to measure the effect of the COVID-19 vaccine administered on women's ovarian reserve tests and in vitro fertilization (IVF) treatment outcomes. This prospectively planned study was conducted in Hüma Gynecology and Obstetrics Hospital, IVF Unit. The study included 187 patients who applied due to infertility between April 2022 and June 2022. The patients were divided into 2 groups according to whether they had the COVID-19 vaccine or not. Follicle Stimulating Hormone (FSH), Estradiol (E2), Anti Müllerian Hormone (AMH) values, and total antral follicle counts (AFS) of 94 patients in the 1st group who accepted to be vaccinated were measured. The same parameters of 93 patients who refused to be vaccinated were also examined. The results of ovarian reserve tests and IVF treatment were compared between these two groups with and without vaccination. When the ovarian reserve tests of the vaccinated patients were evaluated before and after vaccination, no statistically significant difference was found in terms of FSH, AMH, E2, and AFS. No statistically significant difference was observed in the number of oocytes collected, the number of M2 oocytes, fertilization, implantation, and clinical pregnancy rates between the group that received the vaccine and the group that did not receive the vaccine during the IVF treatment process (p>0.05). It has been shown in our study that the COVID-19 vaccine does not reduce ovarian reserve while protecting people from infection. It has also been proven in this study that vaccination before IVF treatment in infertile patients does not adversely affect the treatment process and results.

Keywords

AMH, COVID-19 vaccine, infertility, IVF results, ovarian reserve test

References

• World Health Organization. Coronavirus disease 2019 (COVID-19): Weekly Epidemiological Update, Data as received by WHO from national authorities, as of 10 am CEST 6 September 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200907-weekly-epi-update-4 Erişim tarihi: 07.09.2020
• Kazak A, Hintistan S, Önal B. Dünyada ve Türkiye’de Covid-19 Aşı Geliştirme Çalışmaları. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2020; 7:571-575.
• Wang J, Peng Y, Xu H, Cui Z, Williams RO. The COVID-19 Vaccine Race: Challenges and Opportunities in Vaccine Formulation. AAPS PharmSciTech 2020; 21:225.
• Orvieto R, Noach-Hirsh M, Segev-Zahav A, et al. Does mRNA SARS-CoV-2 vaccine influence patients' performance during IVF-ET cycle? Reprod Biol Endocrinol 2021; 19:69.
• Chen F, Zhu S, Dai Z, et al. Effects of COVID-19 and mRNA vaccines on human fertility. Hum Reprod 2021; 37:5-13.
• Schaler L, Wingfield M. COVID-19 vaccine - can it affect fertility? Ir J Med Sci 2021; 15:1–3.
• Polack FP, Thomas SJ, Kitchin N, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med 2020; 383:2603-2615.
• Does the COVID-19 vaccine affect fertility? Here's what the experts say. Health Care(n.d.). https://www.muhealth.org/our-stories/does-covid-19-vaccine-affect-fertility-heres-what-experts-say Erişim tarihi: 18.08.2021
• Yılmaz Hİ, Turğut B, Çıtlak G ve ark. Türkiye’de İnsanların COVID-19 Aşısına Bakışı. Dicle Tıp Dergisi 2021; 48:583-594.
• Joseph NT, Rasmussen SA, Jamieson DJ. The effects of COVID-19 on pregnancy and implications for reproductive medicine. Fertil Steril 2021; 115:824-830.
• Linehan L, O'Donoghue K, Dineen S, et al. SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19. Placenta 2021; 104:261-266.
• ASRM, ACOG and SMFM Issue Joint Statement: Medical Experts Continue to Assert that COVID Vaccines Do Not Impact Fertility. https://www.asrm.org/news-and-publications/covid-19/covid-19-press-releases-and-announcements/asrm-smfm-acog-issue-joint-statement-medical-experts-continue-to-assert-that-covid-vaccines-do-not-impact-fertility Erişim tarihi: 05.02.2021
• American Society for Reproductive Medicine (2021) Statement from the ASRM COVID-19 Task Force. https://www.asrm.org/news-and-publications/news-and-research/press-releases-andbulletins/statement-from-the-asrm-covid-19-task-force/ Erişim tarihi: 16.06.2021
• Reis FM, Bouissou DR, Pereira VM, et al. Angiotensin-(1-7), its receptor Mas, and the angiotensin-converting enzyme type 2 are expressed in the human ovary. Fertil Steril 2011; 95:176-181.
• Vaz-Silva J, Carneiro MM, Ferreira MC, et al. The vasoactive peptide angiotensin-(1-7), its receptor Mas and the angiotensin-converting enzyme type 2 are expressed in the human endometrium. Reprod Sci 2009; 16:247-256.
• Barreta MH, Gasperin BG, Ferreira R, et al. The components of the angiotensin-(1-7) system are differentially expressed during follicular wave in cattle. J Renin Angiotensin Aldosterone Syst 2015; 16:275-283.
• Pereira VM, Reis FM, Santos RA, et al. Gonadotropin stimulation increases the expression of angiotensin-(1--7) and MAS receptor in the rat ovary. Reprod Sci 2009; 16:1165-1174.
• Mohr-Sasson A, Haas J, Abuhasira S, et al. The effect of Covid-19 mRNA vaccine on serum anti-Müllerian hormone levels. Hum Reprod 2022; 37:534-541.
• Gleicher N, Barad D. Unexplained infertility: does it really exist? Hum Reprod 2006; 21:1951-1955.
• Bentov Y, Beharier O, Moav-Zafrir A, et al. Ovarian follicular function is not altered by SARS-CoV-2 infection or BNT162b2 mRNA COVID-19 vaccination. Hum Reprod 2021; 36:2506-2513.