Female fertility under the impact of COVID-19 pandemic: a narrative review

Wang, Meng; Zhang, Bo; Jin, Lei

doi:10.1017/erm.2021.19

Cited by 6 publications

(10 citation statements)

References 119 publications

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“…On a similar note, COVID-19 infection has also been associated with preeclampsia, preterm birth, and low birthweight in infants. It has been suggested that the effects of COVID-19 infection are likely associated with uteroplacental vasoconstriction and endothelial disfunction due to SARS-CoV-2 modulation of renin-angiotensin-aldosterone system by binding to angiotensin-converting enzyme 2 ( 53 , 54 ). The pathophysiology of uteroplacental blood perfusion and its impact on preterm birth under different scenarios such as SSRI use, gestational hypertension, preeclampsia, and COVID-19 needs to be addressed to improve maternal and fetal health.…”

Section: Discussionmentioning

confidence: 99%

Fluoxetine-induced perinatal morbidity in a sheep model

et al. 2022

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Selective serotonin reuptake inhibitors (SSRI) are the most common antidepressants used by pregnant women. However, adverse pregnancy outcomes have been described in women taking SSRI during pregnancy—placental lesions, premature birth, poor neonatal adaptation. We aimed to investigate the effects of fluoxetine (Prozac® most commonly used SSRI) treatment during the last month of gestation on pregnancy complications, placental and neonatal health in a non-depressed sheep model. On day 119 ± 1 postbreeding (experimental day 0; E0) of a 151-day expected gestation, Hampshire ewes were randomly assigned to receive fluoxetine (n = 9 ewes, 15 lambs; daily intravenously treatment with 10 mg/kg on E0 and E1 and 5 mg/kg daily thereafter until parturition) or to a control group (n = 10; 14 lambs; vehicle only). Blood samples from ewes were collected throughout the experimental period and postpartum; blood from lambs were collected postpartum. Analysis of variance was used for statistical analysis. Fluoxetine treatment reduced placentome growth during the last month of pregnancy. Gestation length was decreased by 4.5 days in fluoxetine-treated ewes. Birthweight was reduced in lambs exposed to fluoxetine in utero; weights remained decreased until postnatal day 3. Placentome diameter by birthweight ratio was not different between groups suggesting that the decreased placentome diameter was accompanied by decreased lamb birthweight. During the first week postnatal, lambs exposed to fluoxetine in utero had decreased blood pH and decreased total carbon dioxide, bicarbonate, and base excess and increased lactate (days 3–6), collectively indicative of metabolic acidemia. Additionally, ionized calcium was decreased between postnatal days 0 to 4 in lambs exposed to fluoxetine in utero. Using a non-depressed animal model clearly defines a role for SSRI on the occurrence of perinatal complications and neonatal morbidity. The decreased placentome diameter, shortened gestation, decreased birthweight, decreased calcium levels, and neonatal acidemia suggest the occurrence of intrauterine growth restriction. The persistence of neonatal acidemia for several days postpartum suggests poor neonatal adaptation to extrauterine environment.

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Section: Discussionmentioning

confidence: 99%

Fluoxetine-induced perinatal morbidity in a sheep model

et al. 2022

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“…Bowman and his team studied the effect on BNT162b2 vaccine on female fertility in rats. They found that it has no impact on fertility, ovarian or uterine parameters and embryo-fetal development 26 . Moreover, another study by Devora Ahron et al, they compared early IVF outcomes between 28 patients who received Pfizer vaccine, 37 patients received the Moderna vaccine and 328 unvaccinated patients who were a control group.…”

Section: Introductionmentioning

confidence: 98%

“…The ACE2 has a vital role in endometrial proliferation and renewal. Accordingly, it is expected that the downregulation of ACE2 by SARS-CoV-2 could affect the endometrial stability and may impair implantation 22 – 26 . Whether this has a noxious effect on the endometrium due to COVID-19 infection or vaccination need to be clarified 27 .…”

Section: Introductionmentioning

confidence: 99%

COVID-19 infection and vaccine have no impact on in-vitro fertilization (IVF) outcome

Albeitawi

Al‐Alami

Hamadneh

et al. 2022

Sci Rep

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To investigate the effect of COVID-19 infection or vaccine on IVF outcome. This is a multicenter retrospective study. Data were collected from all patients treated in the ART units between September and November 2021 after the vaccination of the general population began. Medical records of all patients who had IVF/intracytoplasmic sperm injection (ICSI) were retrospectively reviewed. Patients were categorized into four groups: previously infected by COVID-19, vaccinated by COVID vaccine, previously infected and vaccinated, or neither infected nor vaccinated. Total number of participants 151 (vaccinated only 66, infected only 18, vaccinated and previously infected 34, and control 33. Outcomes (ET on day of trigger, number of oocytes retrieved, quality of oocytes, number of fertilized oocytes, number and quality of embryos, number of embryos transferred, number of embryos frozen, implantation rate and clinical pregnancy rate) were compared between these four groups. Moreover, we compared the outcome before and post infection, as well as before and post vaccine in a group of patients. No evidence was found to suggest that COVID-19 disease or SARS-CoV-2 Vaccine adversely affects Clinical pregnancy rates (positive fetal heartbeat) (OR 0.9, CI 0.5–1.9, OR 1.8, CI 0.9–3.6, respectively) and the following parameters: fertilization rate, implantation rate, positive bHcg) (OR 0.9, CI 0.5–1.8, OR 1.5, CI 0.7–2.9, respectively). Although a limitation of our study is the small comparison groups, and the wide confidence intervals in the Odds Ratio estimates.

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“…Since the ACE2 receptors are highly expressed in uterine, placental, and ovarian cells, there would be possible if COVID‐19 infection can affect fertility in women 13 . Although the effect of vaccination against COVID on fertility is still uncertain, but many studies revealed that vaccination would not affect ovarian reserve 14–16 . It is reported that vaccination can lead to short‐term menstrual alterations 11,17–19 …”

Section: Introductionmentioning

confidence: 99%

“…13 Although the effect of vaccination against COVID on fertility is still uncertain, but many studies revealed that vaccination would not affect ovarian reserve. [14][15][16] It is reported that vaccination can lead to short-term menstrual alterations. 11,[17][18][19] Anti-Müllerian hormone (AMH) is a glycoprotein produced by the ovarian preantral and small antral follicles which are known as a predictor of ovarian reserve estimation.…”

Section: Introductionmentioning

confidence: 99%

The effect of COVID‐19 and COVID‐19 vaccination on serum anti‐Mullerian hormone: A systematic review and meta‐analysis

Ghaemi,

Hantoushzadeh,

Shafiee

et al. 2024

Immunity Inflam & Disease

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ObjectiveThe current study aims to evaluate the impact of COVID‐19 infection and vaccination on ovarian reserve by detecting the anti‐Mullerian hormone (AMH) level.MethodPubMed, Embase, Web of Science, and Scopus has been searched for studies assessing the effect of COVID‐19 infection and/or vaccination on AMH levels up to February 27, 2023. Based on PRISMA 2020 statement criteria, a systematic review and meta‐analysis of included studies were performed. The studies' quality was assessed by the National Institute of Health (NIH) quality assessment tool. The standardized mean difference (MD) of the AMH level was used and the quantitative values of each study were pooled separately by using a random effect model.ResultsOut of 246 studies screened, 18 were included in the systematic review and 14 in the meta‐analysis. Included studies were published between 2021 and 2022 and were conducted in different countries, including the USA (n = 3), China (n = 2), Russia (n = 2), Turkey (n = 5), Israel (n = 3), Czech (n = 2), and Spain (n = 1). Eight studies investigated the effect of SARS‐CoV‐2 infection on AMH levels, and ten studies investigated the possible effect of COVID‐19 vaccination on AMH levels. The pooled analysis showed a statistically significant decrease in AMH levels after COVID‐19 infection (SMD: −0.24; 95% CI: −0.36 to −0.11; I2 = 0%; p = .0003). Vaccination analysis showed a nonstatistically significant change in AMH levels after COVID‐19 vaccination (SMD: −0.11; 95% CI: −0.25 to 0.04; I2 = 35%; p = .14).ConclusionCOVID‐19 infection can result in ovarian reserve injury by reducing the AMH level but getting vaccinated against COVID‐19 has no impact on the AMH level.

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Female fertility under the impact of COVID-19 pandemic: a narrative review

Cited by 6 publications

References 119 publications

Fluoxetine-induced perinatal morbidity in a sheep model

Fluoxetine-induced perinatal morbidity in a sheep model

COVID-19 infection and vaccine have no impact on in-vitro fertilization (IVF) outcome

The effect of COVID‐19 and COVID‐19 vaccination on serum anti‐Mullerian hormone: A systematic review and meta‐analysis

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