Potential effects of COVID-19 on reproductive systems and fertility; assisted reproductive technology guidelines and considerations: a review

Lee, WY; Mok, Alex; Chung, Jacqueline Pui Wah

doi:10.12809/hkmj209078

Cited by 40 publications

(48 citation statements)

References 49 publications

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“…Beyond vasoconstriction, Ang II mediates pro-inflammatory, pro-fibrotic, pro-apoptotic and tissue remodeling properties. On the contrary, Ang-(1-7) shows anti-inflammatory and anti-fibrotic properties ( Bourgonje et al, 2020 ; Lee et al, 2021 ). Infection with SARS-CoV-2 leads to an impaired activity and expression of ACE2.…”

Section: Severe Acute Respiratory Syndrome Coronavirus-2 and Receptormentioning

confidence: 99%

Is There a Role for SARS-CoV-2/COVID-19 on the Female Reproductive System?

et al. 2022

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Coronavirus disease (COVID-19) has emerged as a very serious pandemic caused by the rapidly evolving transmission of the coronavirus SARS-CoV-2. Since its outbreak in 2020, the SARS CoV-2 has represented an important challenge for the physicians due to its well known respiratory sequelae. To date, the role of SARS-CoV-2 infection on organs and systems other than lungs and respiratory tract remains less clear. In particular, it remains to be investigated whether the reproductive system can be affected by the SARS-CoV-2 in the long term-period or, in alternative, drugs used to treat COVID-19 might impact the reproductive systems and, in turn, fertility. What is known is that SARS-Cov-2 binds to target cells of host through different receptors including angiotensin-converting enzyme 2 (ACE2), neuropilin-1, AXL and antibody-FcɣR complexes. ACE2 physiologically regulates both the expression of angiotensin II (Ang II) as well as Ang-(1-7) to exerts its physiological functions. The reproductive system abundantly expresses ACE2 and produces Ang-(1-7), starting from precursors which are locally generated or derived from systemic circulation. Ang-(1-7) plays an important role of stimulus to the growth and maturation of ovarian follicle as well as to ovulation. Also human endometrium expresses Ang-(1-7), mainly during the post-ovulatory phase. Animal and human observational studies demonstrated that Ang-(1-7) is involved in the maternal immune response to pregnancy and its deficiency is associated with a defective placenta development. In our manuscript, we review the current knowledge about whether SARS-CoV-2 may impact the female reproductive system. We further explain the possible molecular mechanism by which SARS-CoV-2 might affect ovarian, endometrial and female genital tract cells.

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Section: Severe Acute Respiratory Syndrome Coronavirus-2 and Receptormentioning

confidence: 99%

Is There a Role for SARS-CoV-2/COVID-19 on the Female Reproductive System?

et al. 2022

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“…Such data cannot exclude the fact that SARS-CoV-2 might attack ovarian tissue and granulosa cells, thereupon the ovarian function may be abnormal and oocyte quality decreased. The downregulation of ACE2 receptor after the viral infection may cause variations in the follicular development and oocyte maturation [20]. In many fertility treatment centers, IVF procedures were postponed.…”

Section: Sars-cov-2 In Female Reproductive Organsmentioning

confidence: 99%

The Impact of SARS-CoV-2 Infection on Fertility and Female and Male Reproductive Systems

Markiewicz-Gospodarek

Wdowiak

Czeczelewski

et al. 2021

JCM

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains a huge challenge for contemporary healthcare systems. Apart from widely reported acute respiratory distress syndrome (ARDS), the virus affects many other systems inducing a vast number of symptoms such as gastrointestinal, neurological, dermatological, cardiovascular, and many more. Currently it has also been hypothesized that the virus might affect female and male reproductive systems; SARS-CoV-2 infection could also have a role in potential disturbances to human fertility. In this article, we aimed to review the latest literature regarding the potential effects of SARS-CoV-2 infection on female and male reproductive systems as well as fertility, in general.

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“…ACE2 is highly expressed in stromal cells, theca cells and granulosa cells, as well as oocytes (Refs 32 , 35 ). In the female reproductive system, ACE2 is predominantly enriched in the ovary (Refs 36 , 37 ), making it a potential target organ for SARS-CoV-2 infection. Moreover, previous studies have demonstrated that ACE2 has been detected in embryos before the 8-cell stage and in trophectoderm cells of late blastocysts, and TMPRSS2 exists in embryos in the late blastocyst stage (Ref.…”

Section: Mechanism Of Infection In the Female Reproductive Systemmentioning

confidence: 99%

“…Furthermore, the decrease in ACE2 activity induced by SARS-CoV-2 infection can increase circulating Ang II, which might alter ovarian function, influence the biological process of oocyte development and maturation, impact oocyte quality and ultimately impair fertility function (Ref. 36 ). In addition, Ang II recruitment also increases oxidative stress (Ref.…”

Section: Mechanism Of Infection In the Female Reproductive Systemmentioning

confidence: 99%

“…Ovaries may be a potential target for SARS-CoV-2 infection (Ref. 36 ), although until now, the impact of viral infections on female fertility has been debated. Ovarian reserve is used to evaluate female fertility, and basal antral follicle count, anti-Müllerian hormone (AMH) and sex hormones, such as follicle-stimulating hormone, luteinising hormone, oestradiol, progesterone and testosterone, are the most frequently utilised indicators of ovarian reserve (Ref.…”

Section: Impacts Of Covid-19 On the Female Reproductive Systemmentioning

confidence: 99%

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

Wang

Zhang

Jin

2021

Expert Rev. Mol. Med.

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Coronavirus disease 2019 (COVID-19) is a serious respiratory disease mediated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The worldwide spread of COVID-19 has caused millions of confirmed cases and morbidity, and the crisis has greatly affected global economy and daily life and changed our attitudes towards life. The reproductive system, as a potential target, is at a high risk of SARS-CoV-2 infection, and females are more vulnerable to viral infection compared with males. Therefore, female fertility and associated reproductive health care in the COVID-19 era need more attention. This review summarises the mechanism of SARS-CoV-2 infection in the female reproductive system and discusses the impact of the COVID-19 crisis on female fertility. Studies have proven that COVID-19 might affect female fertility and interfere with assisted reproductive technology procedures. The side effects of vaccines against the virus on ovarian reserve and pregnancy have not yet been well investigated. In the future, the female fertility after SARS-CoV-2 infection and vaccination needs more attention because of the uncertainty of COVID-19.

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Potential effects of COVID-19 on reproductive systems and fertility; assisted reproductive technology guidelines and considerations: a review

Abstract: Relationships between severe acute respiratory syndrome coronavirus, angiotensinconverting enzyme 2 receptor, and renin-angiotensin systemThis article was published on 15 Apr 2021 at www.hkmj.org.

Cited by 40 publications

References 49 publications

Is There a Role for SARS-CoV-2/COVID-19 on the Female Reproductive System?

Is There a Role for SARS-CoV-2/COVID-19 on the Female Reproductive System?

The Impact of SARS-CoV-2 Infection on Fertility and Female and Male Reproductive Systems

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

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