RATES OF COVID-19 INFECTIONS AMONG INFERTILITY PATIENTS UNDERGOING TREATMENT AT A UNIVERSITY REPRODUCTIVE HEALTH CENTER

The emergence of coronavirus disease 2019 (COVID-19) caused an unprecedented challenge for infertility patients. Clinics have established COVID-19 testing protocols for infertility patients undergoing various treatments. A fundamental gap in knowledge is the incidence of COVID infections among infertility patients compared to other groups of patients. The purpose of this study is to determine the rate of COVID-19 infection among infertility patients compared to other gynecologic surgery patients. This retrospective study evaluated the incidence of COVID-19 infection among patients undergoing in vitro fertilization (IVF), fertility-related surgeries and other gynecologic surgeries at a single academic institution in Los Angeles, California from March 2020 to April 2021. All patients underwent routine COVID-19 PCR screening prior to treatment. Our primary objective was to compare the rate of COVID-19 infection among patients undergoing fertility treatments with the rate among patients undergoing gynecologic surgery for other indications. A total of 2,742 patients underwent asymptomatic COVID-19 screening before a surgical procedure or IVF between March 1, 2020 and April 5, 2021. The rate of COVID-19 infection among patients who underwent preoperative testing for a non-infertility-related gynecologic procedure was 1.73% (n=28). In comparison, the positive test results for those who underwent an infertility-related surgical procedure or IVF were 0.23% (n=1) and 0.44% (n=3) respectively, representing 12.5% of positive tests for the whole cohort. Prior to oocyte retrieval, one patient converted from negative to positive. The infertility patients had a significantly lower positivity rate compared to the other gynecologic patients during routine preoperative COVID-19 testing (0.35% vs 1.73%, p<0.01). Our study demonstrated that there was a significantly lower incidence of asymptomatic COVID-19 infections in infertility patients undergoing IVF or surgery compared to other gynecologic surgery patients. Routine preoperative screening can permit infertility and gynecologic surgeries to resume during a pandemic with a low COVID-19 infection positivity rate and probability of cancellation. Future studies should evaluate the cost-effectiveness of routine screening in both the gynecology and infertility patient population, especially in the setting of different variant surges and vaccination rates.