The Impact of the Covid-19 Pandemic in Terms of Quality of Life and Distress in Infertility, a Questionnaire Study

Abstract

age groups. TL was similar in young groups while in older groups TL was statistically significantly different (134.6 AE 15.95 a.u vs 113.6 AE 12,99 a.u, NZ and OAZ respectively, p ¼ 0.035). Moreover, an accumulation of critically short telomeres was found in older OAZ (3.28 % vs 11.68 %, NZ and OAZ respectively; p ¼ 0.043). To analyse telomere protection, TRF1 levels were studied. In blood, younger OAZ showed lower levels of TRF1 (317.3 AE 49.93 a.u vs 267.7 AE 40.02 a.u, NZ and OAZ respectively; p ¼ 0.010) and accumulated a higher percent of low TRF1 levels at telomeres (16.9% vs 25.22 %, p ¼ 0.001). Regarding ART outcomes, a lower rate of fertilization per Metaphase II oocytes (0.358 AE 0.072 vs 0.811 AE 0.019, p < 0.0001) and a higher rate of abortion (0.277 AE 0.188 vs 0.014 AE 0.014, p ¼ 0.032) was found in older OAZ after intracytoplasmic sperm injection using donor oocytes and transfer.CONCLUSIONS: OAZ patients have a shorter systemic TL already detectable at young age and also patent in sperm at older ages, possibly due to telomere unprotection with low levels of TRF1. Therefore, in OAZ patients, alteration of telomere biology could cause the premature aging of the reproductive system. Additionally, older OAZ had worse ARToutcomes in contrast with NZ, suggesting that correct TL maintenance is a potential molecular marker of sperm quality to consider at older ages, before performing ART.