Validation of the French in vitro fertilization guidelines during the Covid-19 pandemic

Poulain, Marine; Fossard, Camille; Benammar, Achraf; Farfour, Eric; Ranga, Stephanie; Filali, Meryem; Vandame, Jessica; Pirtea, Paul; Vasse, Marc; Racowsky, Catherine; Ayoubi, Jean-Marc

RESEARCH QUESTION: Is a symptom questionnaire per the French IVF guidelines adequate for screening patients during the Covid-19 pandemic? DESIGN: Patients planning IVF from June 2020 through February 2021 were included in the study. In compliance with French IVF guidelines, all fever-free patients on day of oocyte retrieval were screened for risk of Covid-19 by completing a symptom questionnaire after being counseled regarding importance of a Covid-19 free medical practice. Patients cycling between June and September 2020 only completed the questionnaire (Group 1), while those planning IVF after September, also underwent the RT-PCR test for SARS-CoV-2 RNA (Group 2). Cycle cancellation rates between groups were compared. Group 1 patients consented for follicular fluid (FF) testing for SARS-CoV-2 and an interview post-cycle completion to determine Covid-19 exposure during 6 months before and after retrieval. RESULTS: Cycle cancellation rates for Groups 1 and 2 were 0% (0/214) versus 1.4% (8/577), respectively, (p=0.116). All 183 FF samples from Group 1 were negative for SARS-CoV-2 RNA. Of 171 patients interviewed post-IVF, 16 (9.3%) developed COVID-19 symptoms or a positive RT-PCR test, but none within two months pre- or post-retrieval. CONCLUSION: These results provide reassurance that consistent with the Covid-19 French IVF guidelines, use of a symptom questionnaire is effective in screening patients planning to undergo IVF. Failure to detect viral RNA in any FF sample does not negate the possibility that FF is a viral reservoir. However, the findings provide reassurance that the follicular environment in our carefully screened population was COVID-free.