Impact of COVID-19 on fertility and assisted reproductive technology (ART): a systematic review

Abstract

The appearance of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a major obstacle for the performing of current medical activities throughout the world. COVID-19 has affected humanity in many ways, thus causing a great medical, social, economic, and political instability. The aim of this study was to make an analysis of the scientific data obtained by so far to highlight the impact that COVID-19 has had on fertility and assisted reproductive technology (ART). Infection with SARS-CoV-2 alters the normal immune response by local and systemic damage to tissues and organs. After the virus enters the body, the first lesions are produced in the respiratory tract. Extrapulmonary lesions specific to COVID-19 include acute renal lesions/acute kidney damage, hepatocellular lesions, neurological diseases, myocardial dysfunction and arrhythmia, gastrointestinal diseases but also genital impairment. The possible impairment of the male reproductive system is because angiotensin-converting enzyme 2 (ACE2) receptors are in an increased number in the testes, seminiferous duct cells, spermatogonia, Leydig cells and Sertoli cells. Many published studies to date have pointed out that COVID-19 could also affect female fertility and disrupt the functions of the female reproductive system. The theory that this virus can also be transmitted sexually and can cause infertility or testicular damage is supported by the fact that the virus can be isolated in the semen of COVID-19 patients but only during the disease. Choosing the best method of treating infertility during the COVID-19 pandemic is multifactorial, but the risk of infection and compliance with specific ART hygiene protocols must always be considered. Currently, there is no scientific basis regarding the fact that the COVID-19 vaccination would influence fertility.

Clinical Characteristics and Local Histopathological Modulators of Endometriosis and Its Progression

“…Săndulescu, M.S et al observed that the secretion of ectopic endometrial glands into the ovarian cortex led to compression and an increase in PI or SI [52]. We also noted similar findings in this study on EO.…”

Pregnancy Outcomes, Immunophenotyping and Immunohistochemical Findings in a Cohort of Pregnant Patients with COVID-19—A Prospective Study

“…Until now, several studies have outlined an association between SARS-CoV-2 infection and poor pregnancy outcomes [ 5 ]. For example, it was demonstrated that miscarriage, intrauterine death, fetal growth restriction, and high maternal–fetal morbidity rates were more prevalent in patients infected with this type of virus [ 6 , 7 , 8 , 9 , 10 ].…”

COVID-19 Vaccines and Assisted Reproductive Techniques: A Systematic Review

“…Published investigations, as well as previous systematic reviews and meta-analyses, have aimed to answer these questions and clarify the association between COVID-19 and fertility. Many investigators defend that sperm production can be altered, as male gonads can be vulnerable to infection [ 24 , 25 , 26 ]. This can be explained by the presence of angiotensin-converting enzyme 2 (ACE2) receptors, which are abundant in testes, seminiferous duct cells, spermatogonia, Leydig, and Sertoly cells [ 27 , 28 ].…”