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Li XF, Zhang YJ, Yao YL, Chen MX, Wang LL, Wang MD, Hu XY, Tang XJ, Zhong ZH, Fu LJ, Luo X, Lv XY, Geng LH, Wan Q, Ding YB. The association of post-embryo transfer SARS-CoV-2 infection with early pregnancy outcomes in in vitro fertilization: a prospective cohort study. Am J Obstet Gynecol 2024; 230:436.e1-436.e12. [PMID: 38135094 DOI: 10.1016/j.ajog.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The influence of SARS-CoV-2 infection after embryo transfer on early pregnancy outcomes in in vitro fertilization or intracytoplasmic sperm injection-embryo transfer treatment remains inadequately understood. This knowledge gap endures despite an abundance of studies investigating the repercussions of preceding SARS-CoV-2 infection on early pregnancy outcomes in spontaneous pregnancies. OBJECTIVE This study aimed to investigate the association between SARS-CoV-2 infection within 10 weeks after embryo transfer and early pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection treatment. STUDY DESIGN This prospective cohort study was conducted at a single public in vitro fertilization center in China. Female patients aged 20 to 39 years, with a body mass index ranging from 18 to 30 kg/m2, undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, were enrolled between September 2022 and December 2022, with follow-up extended until March 2023. The study tracked SARS-CoV-2 infection time (≤14 days, ≤28 days, and ≤10 weeks after embryo transfer), symptoms, vaccination status, the interval between vaccination and embryo transfer, and early pregnancy outcomes, encompassing biochemical pregnancy rate, implantation rate, clinical pregnancy rate, and early miscarriage rate. The study used single-factor analysis and multivariate logistic regression to examine the association between SARS-CoV-2 infection status, along with other relevant factors, and the early pregnancy outcomes. RESULTS A total of 857 female patients undergoing in vitro fertilization/intracytoplasmic sperm injection treatment were analyzed. In the first stage, SARS-CoV-2 infection within 14 days after embryo transfer did not have a significant negative association with the biochemical pregnancy rate (adjusted odds ratio, 0.74; 95% confidence interval, 0.51-1.09). In the second stage, SARS-CoV-2 infection within 28 days after embryo transfer had no significant association with the implantation rate (36.6% in infected vs 44.0% in uninfected group; P=.181). No statistically significant association was found with the clinical pregnancy rate after adjusting for confounding factors (adjusted odds ratio, 0.69; 95% confidence interval, 0.56-1.09). In the third stage, SARS-CoV-2 infection within 10 weeks after embryo transfer had no significant association with the early miscarriage rate (adjusted odds ratio, 0.77; 95% confidence interval, 0.35-1.71). CONCLUSION Our study suggests that SARS-CoV-2 infection within 10 weeks after embryo transfer may not be negatively associated with the biochemical pregnancy rate, implantation rate, clinical pregnancy rate, and early miscarriage rate in patients undergoing in vitro fertilization/intracytoplasmic sperm injection treatment. It is important to note that these findings are specific to the target population of in vitro fertilization/intracytoplasmic sperm injection patients aged 20 to 39 years, without previous SARS-CoV-2 infection, and with a body mass index of 18 to 30 kg/m2. This information offers valuable insights, addressing current concerns and providing a clearer understanding of the actual risk associated with SARS-CoV-2 infection after embryo transfer.
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Affiliation(s)
- Xue-Fei Li
- Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, China
| | - Yong-Jia Zhang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Ying-Ling Yao
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Ming-Xing Chen
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li-Li Wang
- Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, China
| | - Meng-Di Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xin-Yue Hu
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xiao-Jun Tang
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Zhao-Hui Zhong
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li-Juan Fu
- Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China; Department of Pharmacology, Academician Workstation, Changsha Medical University, Changsha, China
| | - Xin Luo
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xing-Yu Lv
- Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, China
| | - Li-Hong Geng
- Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, China
| | - Qi Wan
- Department of Obstetrics and Gynecology, West China Second Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yu-Bin Ding
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China; Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China.
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Montano M, Victor AR, Griffin DK, Duong T, Bolduc N, Farmer A, Garg V, Hadjantonakis AK, Coates A, Barnes FL, Zouves CG, Greene WC, Viotti M. SARS-CoV-2 can infect human embryos. Sci Rep 2022; 12:15451. [PMID: 36104397 PMCID: PMC9472724 DOI: 10.1038/s41598-022-18906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
The spread of SARS-CoV-2 has led to a devastating pandemic, with infections resulting in a range of symptoms collectively known as COVID-19. The full repertoire of human tissues and organs susceptible to infection is an area of active investigation, and some studies have implicated the reproductive system. The effects of COVID-19 on human reproduction remain poorly understood, and particularly the impact on early embryogenesis and establishment of a pregnancy are not known. In this work, we explore the susceptibility of early human embryos to SARS-CoV-2 infection. By using RNA-seq and immunofluorescence, we note that ACE2 and TMPRSS2, two canonical cell entry factors for SARS-CoV-2, are co-expressed in cells of the trophectoderm in blastocyst-stage preimplantation embryos. For the purpose of viral entry studies, we used fluorescent reporter virions pseudotyped with Spike (S) glycoprotein from SARS-CoV-2, and we observe robust infection of trophectoderm cells. This permissiveness could be attenuated with blocking antibodies targeting S or ACE2. When exposing human blastocysts to the live, fully infectious SARS-CoV-2, we detected cases of infection that compromised embryo health. Therefore, we identify a new human target tissue for SARS-CoV-2 with potential medical implications for reproductive health during the COVID-19 pandemic and its aftermath.
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Săndulescu MS, Văduva CC, Siminel MA, Dijmărescu AL, Vrabie SC, Camen IV, Tache DE, Neamţu SD, Nagy RD, Carp-Velişcu A, Manolea MM. Impact of COVID-19 on fertility and assisted reproductive technology (ART): a systematic review. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:503-510. [PMID: 36588488 PMCID: PMC9926143 DOI: 10.47162/rjme.63.3.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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.
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Affiliation(s)
- Maria Sidonia Săndulescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;
| | - Constantin-Cristian Văduva
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Mirela Anişoara Siminel
- Department of Neonatology, University of Medicine and Pharmacy of Craiova, Romania , Department of Neonatology, Filantropia Municipal Hospital, Craiova, Romania
| | - Anda Lorena Dijmărescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Sidonia Cătălina Vrabie
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Ioana Victoria Camen
- Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania , PhD Student, Doctoral School, University of Medicine and Pharmacy of Craiova, Romania
| | - Daniela Elise Tache
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Romania
| | - Simona Daniela Neamţu
- Department of Hematology and Immunology, University of Medicine and Pharmacy of Craiova, Romania
| | - Rodica Daniela Nagy
- Department of Obstetrics and Gynecology, Emergency County Hospital, Craiova, Romania
| | - Andreea Carp-Velişcu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania , Department of In Vitro Fertilization, Prof. Dr. Panait Sîrbu Clinical Hospital of Obstetrics and Gynecology, Bucharest, Romania
| | - Maria Magdalena Manolea
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
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Helmy Abdelmalek Fahmy E, Yeap BT, Pg Baharuddin DM, M A Abdelhafez M, Than WW, Soe MZ, Hayati F, Chin YS. Obstetric challenges during COVID-19 pandemic: A narrative review. Ann Med Surg (Lond) 2021; 71:102995. [PMID: 34745605 PMCID: PMC8560190 DOI: 10.1016/j.amsu.2021.102995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 12/15/2022] Open
Abstract
The severe acute respiratory coronavirus 2 (COVID-19) pandemic impacts the health of women at reproductive age in different ways, starting from pregnancy planning to post-delivery. This narrative review summarises the challenges to obstetric practice posed by the severe acute respiratory coronavirus 2 (COVID-19) pandemic. In this paper, we highlight the impacts of COVID-19 to obstetric practice globally and the efforts taken to address these challenges. Further study is critical to investigate the effects of COVID-19 on pregnancy, the outcome of COVID-19 positive pregnant women, and the safety of vaccination during pregnancy and breastfeeding.
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Affiliation(s)
- Ehab Helmy Abdelmalek Fahmy
- Obstetrics and Gynaecology Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Boon Tat Yeap
- Department of Anaesthesiology and Intensive Care, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Dg Marshitah Pg Baharuddin
- Obstetrics and Gynaecology Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohsen M A Abdelhafez
- Obstetrics and Gynaecology Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Win Win Than
- Obstetrics and Gynaecology Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - May Zaw Soe
- Department of Medical Education, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Yeung Sing Chin
- Department of Obstetrics and Gynaecology, Sabah Women and Children’s Hospital, Kota Kinabalu, Sabah, Malaysia
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Li F, Zhang H, Shi W, Wu Y, Tian Y, Guo Y, Jin H, Li G. Controlled Ovarian Hyperstimulation Protocol in Infertile Patients During the COVID-19 Pandemic. Front Physiol 2021; 12:732709. [PMID: 34646157 PMCID: PMC8502809 DOI: 10.3389/fphys.2021.732709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/25/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: To explore the appropriate controlled ovarian hyperstimulation (COH) protocols in infertility patients who received the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments during the COVID-19 pandemic. Materials and Methods: This retrospective cohort study evaluated the efficiency of the early follicular-phase long-acting GnRH-agonist long (EFLL) protocol (a new protocol developed by Chinese clinicians), prolonged pituitary down-regulation of EFLL protocol (Pro-EFLL), and the GnRH-ant protocol for couples meeting the study criteria between February 2020 and June 2020 who were treated by the First Affiliated Hospital of Zhengzhou University during the COVID-19 pandemic, and compared the pregnancy rates and miscarriage rates per fresh transfer cycle, number of retrieved oocytes, endometrial thickness on the day of hCG injection and the number of fertilized oocytes, mature oocytes, fertilized oocytes, and transferable embryos among the three protocols. Results: We found that the prolonged pituitary down-regulation during the COVID-19 pandemic by utilizing a full-dose of GnRH-a administrated in infertility patients were no differences in clinical outcomes than other protocols, The prolonged pituitary down-regulation protocol and EFLL protocol were associated with a higher Endometrial thickness on the day of hCG injection (12.67 ± 2.21 vs. 12.09 ± 2.35 vs. 10.79 ± 2.38, P < 0.001), retrieved oocytes (14.49 ± 6.30 vs. 15.02 ± 7.93 vs. 10.06 ± 7.63, P < 0.001), mature oocytes (11.60 ± 5.71 vs. 11.96 ± 6.00 vs. 7.63 ± 6.50, P < 0.001), fertilized oocytes (9.14 ± 5.43 vs. 8.44 ± 5.34 vs. 5.42 ± 5.20, P < 0.001), and transferable embryos (4.87 ± 2.96 vs. 6.47 ± 5.12 vs. 3.00 ± 3.28 vs. P < 0.001) in the GnRH-antagonist protocol. Conclusion: We recommend that patients start Gn injections 33–42 days after a pituitary downregulated full dose (3.75 mg) of gonadotropin-releasing hormone agonist during the COVID-19 pandemic, even a delay of 2–4 weeks does not affect the implantation rate. The study can provide a more detailed estimate and clinical management strategies for infertile couples during the COVID-19 pandemic.
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Affiliation(s)
- Fei Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Center for Reproductive Medicine, The First People's Hospital of Shangqiu, Shangqiu, China
| | - HuiXia Zhang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - WeiYi Shi
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YiFang Wu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ye Tian
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - YiHong Guo
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - HaiXia Jin
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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The Current Evidence Regarding COVID-19 and Pregnancy: Where Are We Now and Where Should We Head to Next? Viruses 2021; 13:v13102000. [PMID: 34696430 PMCID: PMC8541470 DOI: 10.3390/v13102000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the volume of publications dedicated to unraveling the biological characteristics and clinical manifestations of SARS-CoV-2, available data on pregnant patients are limited. In the current review of literature, we present an overview on the developmental course, complications, and adverse effects of COVID-19 on pregnancy. A comprehensive review of the literature was performed in PubMed/Medline, Embase, and Cochrane Central databases up to June 2021. This article collectively presents what has been so far reported on the identified critical aspects, namely complications during pregnancy, delivery challenges, neonatal health care, potential routes of viral transmission, including vertical transmission or breastfeeding, along with the risks involved in the vaccination strategy during pregnancy. Despite the fact that we are still largely navigating uncharted territory, the observed publication explosion in the field is unprecedented. The overwhelming need for data is undoubtable, and this serves as the driver for the plethora of publications witnessed. Nonetheless, the quality of data sourced is variable. In the midst of the frenzy for reporting on SARS-CoV-2 data, monitoring this informational overload is where we should head to next, considering that poor quality research may in fact hamper our attempts to prevail against this unparalleled pandemic outbreak.
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Li J, Fu X, Lv J, Cui L, Li R, Bai A, Wang H, Tang X. Multiple regression analysis of perinatal conditions, physical development, and complications in assisted reproduction singletons. Transl Pediatr 2021; 10:2347-2354. [PMID: 34733675 PMCID: PMC8506065 DOI: 10.21037/tp-21-400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/15/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is no clear clinical conclusion on whether assisted reproductive technology (ART) increases maternal and child risk and affects infant birth and development. This study aimed to perform a multiple regression analysis of the perinatal maternal and infant conditions in an assisted reproductive singleton pregnancy and the physical development and complications of such infants at 6 months old. METHODS This study enrolled 145 singleton pregnant women who were admitted to Luohe Central Hospital between December 2017 and December 2019 to undergo in vitro fertilization and embryo transfer as a research group, and 160 singleton pregnant women who were naturally conceived at the same time and delivered at our hospital were selected as the control group. The relevant data of the patients were collected, and the perinatal conditions, neonatal complications, physical development and NBN score of infants aged 6 months were compared between the two groups. Multivariate logistic regression was used to analyze risk factors for perinatal complications in assisted reproduction singleton pregnancy. RESULTS The incidence of complications in the perinatal period in the study group was significantly higher than that in the control group (P<0.05). However, there was no significant difference in the incidence of complications such as very low birth weight, respiratory distress, neonatal hemolysis, hyperbilirubinemia, hypoglycemia, infectious pneumonia and neonatal asphyxia between the two groups (P>0.05). Likewise, at 6 months of age, the infants in the research group showed no significant difference to the control group in physical development indicators, including weight, head circumference, body mass index, height and NBN score (P>0.05). The analysis of the unconditional multivariate logistic regression model revealed hypertension during pregnancy, placental previa, premature membrane rupture, gestational age <32 weeks, and very low birth weight as risk factors that affect perinatal complications in patients with assisted reproductive singleton pregnancy (P<0.05). CONCLUSIONS The incidence of complications in perinatal patients with assisted reproductive singleton pregnancy is higher than that of natural singleton pregnancy, but there is no significant difference in physical development, NBN score and complications of 6 months old infants.
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Affiliation(s)
- Junfeng Li
- Department of Reproductive Medicine, Luohe Central Hospital of Henan Province, Luohe, China
| | - Xiuhong Fu
- Department of Reproductive Medicine, Luohe Central Hospital of Henan Province, Luohe, China
| | - Jingshang Lv
- Department of Obstetrics and Gynecology, Luohe Central Hospital of Henan Province, Luohe, China
| | - Lina Cui
- Department of Obstetrics and Gynecology, Luohe Central Hospital of Henan Province, Luohe, China
| | - Rongxiang Li
- Department of Reproductive Medicine, Luohe Central Hospital of Henan Province, Luohe, China
| | - Aihong Bai
- Department of Reproductive Medicine, Luohe Central Hospital of Henan Province, Luohe, China
| | - Haoran Wang
- Department of Cardiology, Luohe Central Hospital of Henan Province, Luohe, China
| | - Xian Tang
- Department of Reproductive Medicine, Loudi Central Hospital of Hunan Province, Loudi, China
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Colaco S, Chhabria K, Singh D, Bhide A, Singh N, Singh A, Husein A, Mishra A, Sharma R, Ashary N, Modi D. Expression map of entry receptors and infectivity factors for pan-coronaviruses in preimplantation and implantation stage human embryos. J Assist Reprod Genet 2021; 38:1709-1720. [PMID: 33913101 PMCID: PMC8081283 DOI: 10.1007/s10815-021-02192-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/08/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To predict if developing human embryos are permissive to multiple coronaviruses. METHOD We analyzed publicly available single-cell RNA-seq datasets of human embryos for the known canonical and non-canonical receptors and spike protein cleavage enzymes for multiple coronaviruses like SARS-CoV, SARS-CoV-2, MERS-CoV, hCoV-229E, and hCoV-NL63. We also analyzed the expression of host genes involved in viral replication, host proteins involved in viral endosomal sorting complexes required for transport (ESCRT), genes of host proteins that physically interact with proteins of SARS-CoV-2, and the host genes essential for coronavirus infectivity. RESULTS Of the known receptors of SARS viruses, ACE2, BSG, GOLGA7, and ZDHHC5 were expressed in different proportions in the zygote, 4-cell, 8-cell, morula, and blastocysts including the trophectoderm. The MERS-CoV receptor, DPP4, and hCoV-229E receptor, ANPEP, were expressed mainly from the compact morula to the blastocyst stages. Transcripts of the MERS-CoV alternate receptor LGALS1 were detected in most cells at all stages of development. TMPRSS2 transcripts were detected in the epiblast, primitive endoderm, and trophectoderm, while transcripts of the endosomal proteases CTSL, CTSB, and FURIN were expressed in most cells at all stages of development. ACE2 and TMPRSS2 were co-expressed in a proportion of epiblast and trophectoderm cells. The embryonic cells expressed genes involved in ESCRT, viral replication, SARS-CoV-2 interactions, and coronavirus infectivity. The ACE2 and TMPRSS2 co-expressing cells were enriched in genes associated with lipid metabolism, lysosome, peroxisome, and oxidative phosphorylation pathways. CONCLUSION Preimplantation and implantation stage human embryos could be permissive to multiple hCoVs.
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Affiliation(s)
- S Colaco
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - K Chhabria
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - D Singh
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - A Bhide
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - N Singh
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - A Singh
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
- MGM Institute of Health Sciences, MGM Educational Campus, Sector 1, Kamothe, Navi Mumbai, 410209, India
| | - A Husein
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - A Mishra
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - R Sharma
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - N Ashary
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India
| | - D Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), JM Street, Parel, Mumbai, 400012, India.
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Cruz M, Requena A. How to provide fertility treatment during COVID-19 pandemic. Curr Opin Obstet Gynecol 2021; 33:159-163. [PMID: 33769422 DOI: 10.1097/gco.0000000000000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The emergence of the novel coronavirus infection that arose in Wuhan, China in December 2019 has resulted in an epidemic that has quickly expanded to become one of the most significant public health threats in recent times. The objective of this review is to summarize how this pandemic has affected the activity of a Reproductive Medicine Center, which established a series of measures in parallel with governments decisions and scientific societies. RECENT FINDINGS The control measures adopted for restarting the healthcare activity should be equitable and inclusive. Moreover, this pandemic has implied changes in treatments and strategies to be alert regarding the daily changing information. Finally, for ensuring a safe practice both for patients and staff, it is important to detect asymptomatic patients, so Reproductive Medicine centers must take special care with screening and testing procedures. SUMMARY The pandemic has pushed up toward a new reality in terms of Assisted Reproductive treatments, where social distance and responsibility are protagonists. We face a new challenge of balancing between responding to the committed efforts of infertile couples to achieve pregnancy and safeguarding the health of the future parents and their children during this time of pandemic.
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Affiliation(s)
- M Cruz
- IVI Madrid, Madrid, Spain
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Absence of SARS-CoV-2 (COVID-19 virus) within the IVF laboratory using strict patient screening and safety criteria. Reprod Biomed Online 2021; 42:1067-1074. [PMID: 33814309 PMCID: PMC7937039 DOI: 10.1016/j.rbmo.2021.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 12/17/2022]
Abstract
Research question Is there a risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral exposure and potential cross-contamination from follicular fluid, culture media and vitrification solution within the IVF laboratory using strict patient screening and safety measures? Design This was a prospective clinical study. All women undergoing transvaginal oocyte retrieval were required to have a negative SARS-CoV-2 RNA test 3–5 days prior to the procedure. Male partners were not tested. All cases used intracytoplasmic sperm injection (ICSI). The first tube of follicular fluid aspirated during oocyte retrieval, drops of media following removal of the embryos on day 5, and vitrification solution after blastocyst cryopreservation were analysed for SARS-CoV-2 RNA. Results In total, medium from 61 patients, vitrification solution from 200 patients and follicular fluid from 300 patients was analysed. All samples were negative for SARS-CoV-2 viral RNA. Conclusions With stringent safety protocols in place, including testing of women and symptom-based screening of men, the presence of SARS-CoV-2 RNA was not detected in follicular fluid, medium or vitrification solution. This work demonstrates the possibility of implementing a rapid laboratory screening assay for SARS-CoV-2 and has implications for safe laboratory operations, including cryostorage recommendations.
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