The global outbreak of the coronavirus disease 2019 (COVID-19) led to the suspension of most treatments with assisted reproductive technique (ART). However, with the recent successful control of the pandemic in China, there is an urgent public need to resume full reproductive care. To determine whether the COVID-19 pandemic had any adverse effects on female fertility and the pregnancy outcomes of women undergoing ART, a systematic review and meta-analysis was conducted using the electronic Chinese and English databases. Dichotomous outcomes were summarized as prevalence, and odds ratios (ORs) and continuous outcomes as standardized mean difference (SMD) with 95% confidence interval (CI). The risk of bias and subgroup analyses were assessed using Stata/SE 15.1 and R 4.1.2. The results showed that compared with women treated by ART in the pre-COVID-19 time frame, women undergoing ART after the COVID-19 pandemic exhibited no significant difference in the clinical pregnancy rate (OR 1.07, 95% CI 0.97 to 1.19; I 2 =0.0%), miscarriage rate (OR 0.95, 95% CI 0.79 to 1.14; I 2 =38.4%), embryo cryopreservation rate (OR 2.90, 95% CI 0.17 to 48.13; I 2 =85.4%), and oocyte cryopreservation rate (OR 0.30, 95% CI 0.03 to 3.65; I 2 =81.6%). This review provided additional evidence for gynecologists to guide the management of women undergoing ART treatment during the COVID-19 pandemic timeframe. Electronic Supplementary Material Supplementary material is available in the online version of this article at 10.1631/jzus.B2200154.

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Background: Environmental endocrine disruptor-diethylhexyl phthalate (DEHP) or its active metabolites-mono(2-ethylhexyl) phthalate (MEHP) has the greatest endocrine disrupting potency. The present systematic review and meta-analysis was to investigate the effects of DEHP/MEHP exposure on the folliculogenesis and ovarian steroidogenesis in female rodents. Methods: A search was conducted using EMBASE, PubMed, Web of Science, and Cochrance Library databases. The meta-analyses were performed using mean difference (MD) and random-effects model. Risk of bias and subgroup analyses were assessed using Revman 5.4.1 and R 4.1.2. Registration number: PROSPERO CRD42021292264. Results: A total of 15 studies were included in this systematic review. We found that the exposure of DEHP/MEHP significantly increased the ovary weight (p = 0.003), decreased the serum progesterone levels (p = 0.0008) and delayed the vaginal opening (p = 0.01). Conclusions: The DEHP/MEHP exposure has adverse effects on some aspects of female reproduction ability which tested in female rodent. However, more evidence is needed to strengthen the conclusion.