# Elective fertility preservation before and after the Covid-19 pandemic outbreak

## TL;DR

This study found a significant increase in elective fertility preservation after the start of the Covid-19 pandemic, with no major differences in outcomes.

## Contribution

The study provides new insights into how the pandemic affected fertility preservation decisions and treatment protocols.

## Key findings

- Elective fertility preservation increased significantly after the pandemic outbreak.
- Post-pandemic patients used a progestin-primed protocol and lower gonadotropin doses.
- FP outcomes like oocyte retrieval and embryo cryopreservation were similar before and after the pandemic.

## Abstract

To compare the number and outcomes of elective fertility preservation (FP)
before and after the Covid-19 outbreak.

This retrospective study of 574 women who underwent elective FP between
01/2017-12/2021 included 123 women who underwent the procedure before and
451 who underwent it after the Covid-19 outbreak. The change in the number
of women who underwent the procedure each month before and after the
pandemic was calculated. The ovarian stimulation outcomes were compared
between the two groups.

The post-Covid-19 group included significantly more single women compared to
the pre-Covid-19 group (93.8% vs. 91.1%, p
= 0.024). A progestin-primed ovarian stimulation protocol was followed only
among the women in the post-Covid-19 group (18.8% vs. 0%,
p<0.001), and their gonadotropin dose was
significantly lower than that of the women in the pre-Covid-19 group
(3164.6±842.87 mIU/mL vs. 3426.5±1080.63
mIU/mL, p=0.014). There were no significant group
differences in ovarian stimulation duration (p=0.069), peak
estradiol level (p=0.606), number of retrieved and mature
oocytes (p=0.545 and p=0.364, respectively), oocyte
maturity rate (p=0.719) or the number of women who
cryopreserved embryos (p=0.861). High levels of basal FSH
and low antral follicle counts correlated negatively with the total numbers
of retrieved and mature oocytes.

A rapid and sustained increase in elective FP after the outbreak of the
Covid-19 pandemic that significantly surpassed pre-pandemic levels was
observed. There was no significant difference in FP outcomes between the two
time periods.