Research question

Discontinuation of IVF cycles has been part of the radical transformation of healthcare provision to enable reallocation of staff and resources to deal with the COVID-19 pandemic. This study sought to estimate the impact of cessation of treatment on individual prognosis and US population live birth rates.

Design

Data from 271,438 ovarian stimulation UK IVF cycles was used to model the effect of age as a continuous, yet non-linear, function on cumulative live birth rate. This model was recalibrated to cumulative live birth rates reported for the 135,673 stimulation cycles undertaken in the USA in 2016, with live birth follow-up to October 2018. The effect of a 1-month, 3-month and 6-month shutdown in IVF treatment was calculated as the effect of the equivalent increase in a woman's age, stratified by age group.

Results

The average reduction in cumulative live birth rate would be 0.3% (95% confidence interval [CI] 0.3–0.3), 0.8% (95% CI 0.8–0.8) and 1.6% (95% CI 1.6–1.6) for 1-month, 3-month and 6-month shutdowns. This corresponds to a reduction of 369 (95% CI 360–378), 1098 (95% CI 1071–1123) and 2166 (95% CI 2116–2216) live births in the cohort, respectively. Th e greatest contribution to this reduction was from older mothers.

Conclusions

The study demonstrated that the discontinuation of fertility treatment for even 1 month in the USA could result in 369 fewer women having a live birth, due to the increase in patients’ age during the shutdown. As a result of reductions in cumulative live birth rate, more cycles may be required to overcome infertility at individual and population levels.

中文翻译：

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在COVID-19大流行期间停止试管婴儿对人口的影响。

研究问题

停止试管婴儿周期已成为医疗保健服务彻底转型的一部分，以使人员和资源的重新分配能够应对COVID-19大流行。这项研究试图评估停止治疗对个人预后和美国人口活产率的影响。

设计

来自271,438个卵巢刺激UK IVF周期的数据被用来模拟年龄作为连续但非线性的函数对累积活产率的影响。将该模型重新校准为报告的2016年在美国进行的135,673次刺激周期的累计活产婴儿出生率，并对活产婴儿随访到2018年10月。IVF停产1个月，3个月和6个月的影响治疗的计算方法是按年龄段将妇女的年龄平均增加的影响。

结果

1个月的平均活产出生率平均下降为0.3％（95％置信区间[CI] 0.3-0.3），0.8％（95％CI 0.8-0.8）和1.6％（95％CI 1.6-1.6）。 ，3个月和6个月的关机时间。这对应于该队列中的活产数分别减少了369（95％CI 360-378），1098（95％CI 1071-1123）和2166（95％CI 2116-2216）。减少老年母亲的最大贡献。

结论

该研究表明，由于停产期间患者年龄的增加，在美国甚至停止生育治疗甚至1个月也可以减少369名活产妇女。由于累计活产婴儿出生率下降，可能需要更多的周期才能克服个人和人口水平的不孕症。