Effects of COVID-19 and mRNA vaccines on human fertility

Abstract

The coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has precipitated a global health crisis of unprecedented proportions. Because of its severe impact, multiple COVID-19 vaccines are being rapidly developed, approved and manufactured. Among them, mRNA vaccines are considered as ideal candidates with special advantages to meet this challenge. However, some serious adverse events have been reported after their application, significantly increasing concerns about the safety and efficacy of the vaccines and doubts about the necessity of vaccination. Although several fertility societies have announced that COVID-19 mRNA vaccines are unlikely to affect fertility, there is no denying that the current evidence is very limited, which is one of the reasons for vaccine hesitancy in the population, especially in pregnant women. Herein, we provide an in-depth discussion on the involvement of the male and female reproductive systems during SARS-CoV-2 infection or after vaccination. On one hand, despite the low risk of infection in the male reproductive system or fetus, COVID-19 could pose an enormous threat to human reproductive health. On the other hand, our review indicates that both men and women, especially pregnant women, have no fertility problems or increased adverse pregnancy outcomes after vaccination, and, in particular, the benefits of maternal antibodies transferred through the placenta outweigh any known or potential risks. Thus, in the case of the rapid spread of COVID-19, although further research is still required, especially a larger population-based longitudinal study, it is obviously a wise option to be vaccinated instead of suffering from serious adverse symptoms of virus infection.

Reported Adverse Effects and Attitudes among Arab Populations Following COVID-19 Vaccination: A Large-Scale Multinational Study Implementing Machine Learning Tools in Predicting Post-Vaccination Adverse Effects Based on Predisposing Factors

“…The most redundant side effects were lower back pain, menstrual dysfunctions, and erectile dysfunction and loss of libido (sex drive), n = 54, 39, and 12, respectively. Although the current evidence of COVID-19 vaccines’ effect on fertility is very limited, and several fertility societies have excluded this possible effect, it remains one of the reasons for vaccine hesitancy, especially among pregnant women or those who are trying to get pregnant [ 117 ]. Recently, undocumented reports have been raised about the potential adverse effects of COVID-19 vaccines on the menstrual cycle.…”

COVID-19 vaccines in patients with cancer: immunogenicity, efficacy and safety

“…Common reasons for vaccine hesitancy include concerns regarding vaccine safety, misperception of the risks associated with the disease and/or persistent beliefs in misinformation. Importantly, certain examples of misinformation, such as the potential to increase the rate of miscarriage, regardless of a lack of any evidential basis when originally suggested, have been specifically disproven 189 , 190 . For patients with cancer, there is both no evidence and no rationale whatsoever supporting the suggestion that vaccination against COVID-19 leads to cancer recurrence.…”

Understanding on the possible routes for SARS CoV-2 invasion via ACE2 in the host linked with multiple organs damage

“…In this context, female patients infected by SARS-CoV-2 were noted for ovarian damage, including deteriorated ovarian reserve and reproductive endocrine disorder ( Ding et al, 2021 ). Moreover, the presence of SARS-CoV-2 was also detected in vaginal swabs ( Barber et al, 2021 ; Schwartz et al, 2021 ; Scorzolini et al, 2020 ); however, the general impact of SARS-CoV-2 infection on the female reproductive system and function remained unclear ( Chen et al, 2021a ).…”