LONG-TERM IMPACT OF COVID-19 PANDEMIC ON ART-MEDIATED BITHS IN LOMBARDY, ITALY - COGI 2023 The 31st World Congress on Controversies in Obstetrics, Gynecology & Infertility

Francesca Filippi ¹ Giovanna Esposito ² Edgardo Somigliana ^1,2 Paola Viganò ¹ Matteo Franchi ³ Giovanni Corrao ³ Fabio Parazzini ²

¹ART Unit, Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan
²Department of Clinical Sciences and Community Health, University of Milan, Milan
³Laboratory of Healthcare Research & Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan

Poblem Statment: What is the overall impact of the COVID-19 pandemic on assisted reproductive technology (ART)-mediated birth rates?

Methods: We retrieved data from regional registries of Lombardy, a large area of about 10 million inhabitants that experienced one of the deadliest COVID-19 outbreaks in the world. Deliveries occurring between 1st January 2019 and 31th December 2022 were considered. The absolute number of ART-mediated births per month after the advent of the pandemic was compared with the prepandemic period (2019).

Results: The number of ART-mediated births per month and percentage variation compared to the same month of 2019, are presented in the figure. The grey columns represent the number of births. The red points and the red line connecting them represent the variations compared to 2019 data. The horizontal black continuous line represents the 0% variation.

A considerable decrease in ART-mediated births emerged in December 2020 (-86.6%), January 2021 (-99.2%), and February 2021 (-57.8%). The number of ART-mediated births occurred in 2021 remained lower than in 2019 approximately throughout the entire year. Conversely, during 2022, the absolute number of ART-mediated births was higher than that observed in the prepandemic period (+13.8%, 95%CI: + 8.3% to +19.4%), with the highest variation in August (+33.0%). Throughout the entire study period we observed the delayed effects of holidays, with lower conceptions in July-August (summer holidays) and late December and early January (Christmas holidays) causing the declines in ART-mediated births in the following April-May and September.

Conclusion: The restrictions on ART clinics’ activities had a marked effect on the number of ART-mediated births. Number of births declined in 2020 and 2021 but then boosted-up in 2022. The overall detrimental impact was attenuated if not compensated by this latter recover.