Investigating the impact of asymptomatic or mild SARS-CoV-2 infection on female fertility and in vitro fertilization outcomes: A retrospective cohort study

Wang, Meng; Yang, Qiyu; Ren, Xiaohan; Hu, Juan; Zhou, Li; Long, Rodney; Xi, Qingsong; Zhu, Lixia; Jin, Lei

doi:10.1016/j.eclinm.2021.101013

Cited by 77 publications

(66 citation statements)

References 44 publications

(48 reference statements)

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“…The levels of FSH and AMH were measured during day 2 or 3 of menstruation and AFC was calculated by transvaginal ultrasound. They observed no differences between women with IgG for SARS-CoV-2 and the control group [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…They compared the number of the retrieved oocytes, the mature oocyte rate, the fertilization rate, and the blastocyst formation rate, but only the latter was significantly lower ( p = 0.02). There was no difference between results in the biochemical pregnancy rate, early miscarriage rate, and clinical pregnancy rate [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding hormones and ovarian reserve, several studies showed that SARS-CoV-2 has no impact on serum AMH and HSPG2 in follicular fluid. They monitored AMH in recovered patients both from mild COVID-19 infection and from severe disease (hospitalized patients) [ 44 , 46 , 47 , 48 ]. The FSH level was higher in patients at the start of the IVF cycle during the pandemic, compared to patients before it, in two of the studies reviewed [ 44 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Existent studies show the detrimental impact oxidative stress has on the quality of oocytes and embryos, implying that SARS-CoV-2 could alter female fertility [ 72 , 73 , 74 ]. In this regard, the obtained results by Wang et al show a significantly lower rate of blastocyst formation, despite the similar number of oocytes, fertilization, implantation, abortion, and clinical pregnancy rate [ 46 ]. Similarly, Orvieto et al found a low TQE rate in 9 couples undergoing IVF procedures in their clinic before and after COVID-19 infection, but they evaluated day-3 embryos.…”

Section: Discussionmentioning

confidence: 99%

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The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

Carp-Velişcu

Mehedințu

Frîncu

et al. 2022

IJERPH

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As the coronavirus pandemic is far from ending, more questions regarding the female reproductive system, particularly fertility issues, arise. The purpose of this paper is to bring light upon the possible link between COVID-19 and women’s reproductive health. This review emphasizes the effect of SARS-CoV-2 on the hormones, endometrium and menstrual cycle, ovarian reserve, follicular fluid, oocytes, and embryos. The results showed that endometrial samples did not express SARS-CoV-2 RNA. Regarding the menstrual cycle, there is a large range of alterations, but they were all reversible within the following months. The ovarian reserve was not significantly affected in patients recovering from both mild and severe infection in most cases, except one, where the levels of AMH were significantly lower and basal follicle-stimulating hormone (FSH) levels were increased. All COVID-19 recovered patients had positive levels of SARS-CoV-2 IgG in the follicular fluid. The amount of retrieved and mature oocytes and the fertilization rate were unharmed in three studies, except for one study, where the quantity of retrieved and mature oocytes was reduced in patients with higher levels of SARS-CoV-2 antibodies. The numbers of blastocysts, top-quality embryos, and euploid embryos were affected in most of the studies reviewed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

Carp-Velişcu

Mehedințu

Frîncu

et al. 2022

IJERPH

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show abstract

“…found that SARS-CoV-2 infection in females might not negatively affect female fertility and embryo development by analysing assisted reproductive technology (ART) data (Ref. 107 ). The study compared the embryo outcomes of females with and without a history of SARS-CoV-2 infection via propensity score matching and found that the ovarian reserves and ovarian responses between groups were similar, as were the proportions of mature oocytes, fertilised oocytes, high-quality embryos and available blastocysts.…”

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

confidence: 99%

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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Association of SARS-CoV-2 Infection During Controlled Ovarian Stimulation With Oocyte- and Embryo-Related Outcomes

Fen

et al. 2023

JAMA Netw Open

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ImportanceSARS-CoV-2 infection has had significant effects on the health of people worldwide. Whether SARS-CoV-2 infection during controlled ovarian stimulation (COS) is associated with laboratory outcomes in assisted reproductive technology remains unclear.ObjectiveTo investigate the association between SARS-CoV-2 infection during COS with oocyte- and embryo-related outcomes.Design, Setting, and ParticipantsA multicenter cohort study was conducted of couples undergoing assisted reproductive technology treatments in 7 reproductive centers in 4 provinces in China from October 1, 2022, to December 31, 2022. All couples received nucleic acid testing for SARS-CoV-2 during COS. The SARS-CoV-2–positive group included couples in which either partner was infected with SARS-CoV-2. The SARS-CoV-2–negative group comprised couples without infection.ExposureIn the SARS-CoV-2–positive group, either partner was infected with SARS-CoV-2 during COS, defined as a positive test result for the SARS-CoV-2 antigen.Main Outcomes and MeasuresPrimary outcomes were the available embryo and blastocyst and top-quality embryo and blastocyst rates. Secondary outcomes were the number of oocytes retrieved, the mature oocyte rate, normal fertilization (2 pronuclei observed on day 1 after insemination [2PN]), oocyte degeneration, 2PN cleavage, and blastocyst formation rates.ResultsA total of 585 heterosexual couples with infertility participated in the study (median [IQR] age for female partners, 33 [30-37] years), with 135 couples in the SARS-CoV-2–positive group and 450 in the SARS-CoV-2–negative group. The characteristics of the groups were similar. The SARS-CoV-2–positive group had a significantly lower top-quality embryo rate (odds ratio [OR], 0.83; 95% CI, 0.71-0.96), top-quality blastocyst rate (OR, 0.59; 95% CI, 0.45-0.77), available blastocyst rate (OR, 0.70; 95% CI, 0.59-0.82), and blastocyst formation rate (OR, 0.61; 95% CI, 0.52-0.71) than the SARS-CoV-2–negative group. Analysis of the associations of infection by sex showed that the female positive group had impaired oocyte and embryo quality regarding mature oocyte rate, 2PN cleavage rate, top-quality embryo rate, blastocyst formation rate, available blastocyst rate, and top-quality blastocyst rate compared with the SARS-CoV-2–negative group. Compared with the SARS-CoV-2–negative group, the male positive group and the group of couples with both positive partners had significantly decreased available blastocyst rate, top-quality blastocyst rate, and blastocyst formation rate compared with the SARS-CoV-2 negative group.Conclusions and RelevanceIn this cohort study, SARS-CoV-2 infection during COS was negatively associated with embryo and blastocyst quality. Reproductive physicians should be more attentive to patients with SARS-CoV-2 infection during COS and should give couples who have been infected adequate counseling.

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Investigating the impact of asymptomatic or mild SARS-CoV-2 infection on female fertility and in vitro fertilization outcomes: A retrospective cohort study

Cited by 77 publications

References 44 publications

The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

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

Association of SARS-CoV-2 Infection During Controlled Ovarian Stimulation With Oocyte- and Embryo-Related Outcomes

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