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

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.