We assessed the impact of the COVID-19 pandemic on the pregnancy outcomes of patients who used assisted reproductive technology. We conducted a population-based cohort study of 443,101 patients who conceived naturally or with assisted reproductive technology between December 2015 and July 2021 and had a delivery in hospitals of Quebec, Canada. The main exposure measure was use of assisted reproductive technology before or during the pandemic. Outcomes included preeclampsia, preterm birth, and other pregnancy complications. We used adjusted log-binomial regression models to estimate risk ratios (RR) and 95% confidence intervals (CI) for the association of assisted reproductive technology with adverse pregnancy outcomes compared with natural conception before vs. during the pandemic. In secondary analyses, we examined the association of COVID-19 infection with pregnancy outcomes among women who used assisted reproductive technology. Compared with natural conception, assisted reproductive technology was associated with an increased risk of preeclampsia (RR 1.43; 95% CI 1.21–1.68), preterm birth (RR 2.07; 95% CI 1.84–2.33), and low birth weight (RR 1.94; 95% CI 1.72–2.20) during the pandemic. However, the same risks were also present before the pandemic. Compared with no infection, COVID-19 infection was not associated with adverse outcomes among women who conceived with assisted reproductive technology. This study suggests that the COVID-19 pandemic did not significantly impact the pregnancy outcomes of women who underwent assisted reproductive procedures in Quebec. The findings are reassuring for patients concerned about the potential reproductive effects of the pandemic.

我们评估了 COVID-19 大流行对使用辅助生殖技术的患者妊娠结局的影响。我们对 2015 年 12 月至 2021 年 7 月期间自然受孕或辅助生殖技术并在加拿大魁北克省医院分娩的 443,101 名患者进行了一项基于人群的队列研究。主要的暴露措施是在大流行之前或期间使用辅助生殖技术。结果包括先兆子痫、早产和其他妊娠并发症。我们使用调整后的对数二项式回归模型来估计与大流行之前和期间的自然受孕相比，辅助生殖技术与不良妊娠结局之间的关联的风险比 (RR) 和 95% 置信区间 (CI)。在二次分析中，我们研究了使用辅助生殖技术的女性中 COVID-19 感染与妊娠结局的关联。与自然受孕相比，辅助生殖技术与先兆子痫（RR 1.43；95% CI 1.21-1.68）、早产（RR 2.07；95% CI 1.84-2.33）和低出生体重（RR 1.94；95% CI 1.21-1.68）风险增加相关。大流行期间 95% CI 1.72–2.20）。然而，在大流行之前也存在同样的风险。与未感染相比，COVID-19 感染与采用辅助生殖技术受孕的女性的不良后果无关。这项研究表明，COVID-19 大流行并未对魁北克省接受辅助生殖手术的妇女的妊娠结局产生重大影响。这些发现让担心这一流行病潜在生殖影响的患者感到安心。