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Xu Q, Mao X, Zhang J, Wu L. Immediate application of frozen-thawed embryo transfer cycle in month following COVID-19 recovery does not impair ongoing pregnancy outcome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 64:388-394. [PMID: 38437458 DOI: 10.1002/uog.27630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To investigate whether immediate frozen-thawed embryo transfer (FET) in the next month following coronavirus disease 2019 (COVID-19) recovery affects ongoing pregnancy outcome. METHODS This was a retrospective cohort study carried out at a university-affiliated reproductive medicine center. The study group (post-COVID-19 group) comprised women who were affected by COVID-19 in December 2022 and immediately underwent FET in January 2023 after recovery, with transferred embryos not exposed to the infection. The control group comprised women treated during the pre-COVID-19 period (January 2019). Multivariable logistic regression analysis and a propensity score matching (PSM) approach were used to control for potential confounders and selection bias. RESULTS A total of 200 women were included in the post-COVID-19 group and 641 women were enrolled in the control group. The rate of ongoing pregnancy was comparable between the study cohorts in both the unadjusted and confounder-adjusted logistic regression models. Other reproductive outcomes, including the odds of a positive pregnancy test, implantation, clinical pregnancy and early pregnancy loss, were similar between the comparison groups. PSM models further confirmed the lack of significant differences in pregnancy outcome between the post-COVID-19 group and the control group. CONCLUSIONS Among patients affected by COVID-19 for whom the transferred embryos were generated prior to infection, an immediate FET cycle in the next month after recovery does not seem to compromise ongoing pregnancy outcome. Thus, women who have frozen embryos from preinfection cycles should be counseled and encouraged to undergo FET as soon as possible after COVID-19 recovery. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- Q Xu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - X Mao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Zhang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - L Wu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Huang J, Fang Z, Wu X, Xia L, Liu Y, Wang J, Su Y, Xu D, Zhang K, Xie Q, Chen J, Liu P, Wu Q, Tan J, Kuang H, Tian L. Transcriptomic responses of cumulus granulosa cells to SARS-CoV-2 infection during controlled ovarian stimulation. Apoptosis 2024; 29:649-662. [PMID: 38409352 DOI: 10.1007/s10495-024-01942-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 02/28/2024]
Abstract
Cumulus granulosa cells (CGCs) play a crucial role in follicular development, but so far, no research has explored the impact of SARS-CoV-2 infection on ovarian function from the perspective of CGCs. In the present study, we compared the cycle outcomes between infected and uninfected female patients undergoing controlled ovarian stimulation, performed bulk RNA-sequencing of collected CGCs, and used bioinformatic methods to explore transcriptomic changes. The results showed that women with SARS-CoV-2 infection during stimulation had significantly lower number of oocytes retrieved and follicle-oocyte index, while subsequent fertilization and embryo development were similar. CGCs were not directly infected by SARS-CoV-2, but exhibited dramatic differences in gene expression (156 up-regulated and 65 down-regulated). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses demonstrated a high enrichment in antiviral, immune and inflammatory responses with necroptosis. In addition, the pathways related to telomere organization and double strand break repair were significantly affected by infection in gene set enrichment analysis. Further weighted gene co-expression network analysis identified a key module associated with ovarian response traits, which was mainly enriched as a decrease of leukocyte chemotaxis and migration in CGCs. For the first time, our study describes how SARS-CoV-2 infection indirectly affects CGCs at the transcriptional level, which may impair oocyte-CGC crosstalk and consequently lead to poor ovarian response during fertility treatment.
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Affiliation(s)
- Jialyu Huang
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Zheng Fang
- Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Xingwu Wu
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Leizhen Xia
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Yuxin Liu
- Department of Clinical Medicine, School of Queen Mary, Nanchang University, Nanchang, China
| | - Jiawei Wang
- Reproductive and Genetic Hospital, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Yufang Su
- Department of Oncology, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, Nanchang, China
| | - Dingfei Xu
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Ke Zhang
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Qiqi Xie
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Jia Chen
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Peipei Liu
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Qiongfang Wu
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China
| | - Jun Tan
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China.
| | - Haibin Kuang
- Department of Physiology, Jiangxi Provincial Key Laboratory of Reproductive Physiology and Pathology, School of Basic Medical Sciences, Nanchang University, 461 Bayi Avenue, Nanchang, China.
| | - Lifeng Tian
- Center for Reproductive Medicine, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang Medical College, 318 Bayi Avenue, Nanchang, 330006, China.
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Hu X, Feng G, Chen Q, Sang Y, Chen Q, Wang S, Liu S, Bai L, Zhu Y. The impact and inflammatory characteristics of SARS-CoV-2 infection during ovarian stimulation on the outcomes of assisted reproductive treatment. Front Endocrinol (Lausanne) 2024; 15:1353068. [PMID: 38726341 PMCID: PMC11079226 DOI: 10.3389/fendo.2024.1353068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Despite the global prevalence of coronavirus disease 2019 (COVID-19), limited research has been conducted on the effects of SARS-CoV-2 infection on human reproduction. The aims of this study were to investigate the impact of SARS-CoV-2 infection during controlled ovarian stimulation (COS) on the outcomes of assisted reproductive treatment (ART) and the cytokine status of patients. Methods This retrospective cohort study included 202 couples who received ART treatment, 101 couples infected with SARS-CoV-2 during COS and 101 matched uninfected couples. The parameters of ovarian stimulation and pregnancy outcomes were compared between the two groups. The All-Human Inflammation Array Q3 kit was utilized to measure cytokine levels in both blood and follicular fluid. Results No difference was found in the number of good-quality embryos (3.3 ± 3.1 vs. 3.0 ± 2.2, P = 0.553) between the infected and uninfected groups. Among couples who received fresh embryo transfers, no difference was observed in clinical pregnancy rate (53.3% vs. 51.5%, P = 0.907). The rates of fertilization, implantation, miscarriage, ectopic pregnancy and live birth were also comparable between the two groups. After adjustments were made for confounders, regression models indicated that the quality of embryos (B = 0.16, P = 0.605) and clinical pregnancy rate (P = 0.206) remained unaffected by SARS-CoV-2 infection. The serum levels of MCP-1, TIMP-1, I-309, TNF-RI and TNF-RII were increased, while that of eotaxin-2 was decreased in COVID-19 patients. No significant difference was found in the levels of cytokines in follicular fluid between the two groups. Conclusion Asymptomatic or mild COVID-19 during COS had no adverse effects on ART outcomes. Although mild inflammation was present in the serum, it was not detected in the follicular fluid of these patients. The subsequent immune response needs further investigation.
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Affiliation(s)
- Xiaoling Hu
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Guofang Feng
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qichao Chen
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yimiao Sang
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qingqing Chen
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Sisi Wang
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shuangying Liu
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Long Bai
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
| | - Yimin Zhu
- Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, China
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Cao M, Han Y, Feng T, Lu P, Wang Y, Sun Q, Zhao Z, Pan W. Impact of COVID-19 convalescence on pregnancy outcomes in patients undergoing IVF/ICSI during fresh ART cycles: a retrospective cohort study. Front Endocrinol (Lausanne) 2024; 14:1298995. [PMID: 38348053 PMCID: PMC10860335 DOI: 10.3389/fendo.2023.1298995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/20/2023] [Indexed: 02/15/2024] Open
Abstract
Objective The aim was to study the impact of coronavirus disease 2019 (COVID-19) convalescence on female fertility and laboratory and clinical outcomes in fresh assisted reproductive technology (ART) cycles. Methods In this retrospective cohort study, we analyzed data from 294 patients who had recovered from COVID-19 and who underwent fresh ART cycles between January and March 2023 (COVID-19 group). This group was compared with 631 patients who underwent similar ART cycles in the same period in 2022 but without having been infected with COVID-19 (non-COVID-19 group). The analysis focused on comparison of basic demographic characteristics and laboratory parameters of patients in each group. The primary outcome measure was the clinical pregnancy rate, which was examined to assess the impact of COVID-19 infection on the efficacy of ART treatment. Results Basal follicle-stimulating hormone (FSH) levels were significantly lower and antral follicle count (AFC) was markedly higher in the COVID-19 group compared to the non-COVID-19 group (P<0.001 and P=0.004, respectively). The predominant ovarian stimulation protocol in the COVID-19 group was GnRH antagonists (64.85%, P<0.001), with a reduced gonadotropin (Gn) dosage and duration in comparison to the non-COVID-19 group (P<0.05). Although the number of blastocysts formed was lower in the COVID-19 group (P=0.017), this group also exhibited a higher blastocyst freezing rate and a higher rate of high-quality embryos per retrieved oocyte (P<0.001 and P=0.023, respectively). Binary logistic regression analysis indicated that COVID-19 convalescence did not significantly impact clinical pregnancy rates in fresh transfer cycles (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.68-1.96, P=0.5874). However, smooth curve-fitting and threshold effect analysis revealed an age-related decline in clinical pregnancy rates in both groups, more pronounced in the COVID-19 group, for women aged over 38 years, with the likelihood of clinical pregnancy decreasing by 53% with each additional year of age (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.61-1.08, P=0.1460; odds ratio [OR] = 0.47, 95% CI = 0.21-1.05, P=0.0647). Conclusions Our findings present no substantial evidence of adverse effects on clinical pregnancy outcomes in fresh ART cycles in patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) during the period of convalescence from COVID-19. However, age emerges as a significant factor influencing these outcomes. Notably, for women above 38 years of age, the likelihood of clinical pregnancy in patients with a prior COVID-19 infection decreased by 53% with each additional year. This highlights the importance of considering maternal age, especially in the context of COVID-19, when evaluating the likelihood of successful pregnancy following ART treatments.
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Affiliation(s)
- Mingya Cao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yan Han
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tengfei Feng
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Peiyang Lu
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yue Wang
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qingyun Sun
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiming Zhao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wensen Pan
- Second Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Kaur H, Chauhan A, Mascarenhas M. Does SARS Cov-2 infection affect the IVF outcome - A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 292:147-157. [PMID: 38006819 DOI: 10.1016/j.ejogrb.2023.11.027] [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: 09/26/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
STUDY QUESTION What is the effect of SARS Cov-2 on IVF outcome? SUMMARY ANSWER Mild or asymptomatic Covid-19 infection does not appear to affect clinical or ongoing pregnancy rate after IVF. WHAT IS ALREADY KNOWN Covid-19 has been shown to affect female and male fertility and reproductive function. Studies have shown variable results regarding impact of Covid-19 on IVF outcome with few reporting impaired ovarian reserve, oocyte and embryo quality, semen parameters, clinical pregnancy rate (CPR) and live birth rate (LBR) while others reported no effect on IVF outcome. STUDY DESIGN, SIZE, DURATION An electronic database search of PubMed, EMBASE, SCOPUS, WHO Covid-19 database, Clinical trials.gov and Cochrane Central was performed for articles published in English language between 1st January 2020 and 15th October 2022 by two independent reviewers using predefined eligibility criteria We have included observational studies both prospective and retrospective, cohort studies, and case control studies and excluded narrative reviews, case studies, cost-effectiveness studies or diagnostic studies. Risk of bias was assessed using NOS and quality of evidence was graded by GRADE pro. PARTICIPANTS, SETTINGS, METHODS Studies comparing women undergoing IVF and comparing Covid-19 affected with those unaffected by Covid-19 were included. Also, studies comparing immune group (infected or vaccinated) in the study group and unaffected as controls (historical controls, IVF cycles done prior to Covid-19 outbreak but matched with study group) were included. Those with no comparison group or published in language other than English language or duplicate studies were excluded. MAIN RESULTS AND ROLE OF CHANCE We identified 5046 records and after full text screening of 82 studies, 12 studies were selected for final review. For the clinical pregnancy rate, there was no difference in the CPR in covid recovered or control patients (OR 0.90, 95 % CI = 0.67 to1.21; I2 = 29 %). Similarly, there was no significant effect on implantation rate (RR 0.92, 95 % CI = 0.68 to1.23; I2 = 31 %) and ongoing pregnancy rate (RR 0.96, 95 % CI = 0.79 to 1.15;I2 = 21 %). The mean number of the oocyte retrieved per patient was not significantly different in both the groups (mean difference 0.52, 95 % CI = -1.45 to 2.49; I2 = 75 %). The certainty of the evidence was low. LIMITATIONS The meta-analysis is based on observational studies each involving small number of participants. Few studies reported outcomes as per patient while others reported as per cycle, for uniformity we have reported outcomes as per cycle. Sample size in most of studies was small. WIDER IMPLICATIONS OF FINDINGS This systematic review has not shown any significant effect on the outcome of IVF cycles in patients post Covid-19 recovery compared to controls. But given the sample size, the findings should be considered with caution. REGISTRATION The review protocol has been registered on PROSPERO (registration number CRD42022314515).
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Affiliation(s)
- Harpreet Kaur
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh 174001, India.
| | - Anil Chauhan
- Evidence-Based Health Informatics Unit, Regional Resource Centre, Dept. of Telemedicine, Post Graduate Institute of Medical Education & Research Chandigarh, 160012, India
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Samama M, Entezami F, Rosa DS, Sartor A, Piscopo RCCP, Andersen ML, Cunha-Filho JS, Jarmy-Di-Bella ZIK. COVID-19: A Challenge to the Safety of Assisted Reproduction. Sleep Med Clin 2023; 18:489-497. [PMID: 38501521 PMCID: PMC10288308 DOI: 10.1016/j.jsmc.2023.06.012] [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] [Indexed: 03/20/2024]
Abstract
There is an increased risk of becoming pregnant through fertility treatments using assisted reproductive technology (ART) during the COVID-19 pandemic. The aim of this review is to gather comprehensive data from the existing literature on the potential risks of fertility management during the pandemic period, and outline strategies to mitigate them, with a focus on the hormonal and surgical procedures of ART. A comprehensive search of the scientific literature on COVID-19 in relation to fertility was conducted in the PubMed database using the keywords "coronavirus," "COVID-19," "SARS-CoV-2" and "pregnancy," "fertility," "urogenital system," "vertical transmission," "assisted human reproduction," "controlled ovarian stimulation," "oocyte retrieval," "in vitro fertilization," "hormones," "surgical procedures," "embryos," "oocytes," "sperm," "semen," "ovary," "testis," "ACE-2 receptor," "immunology," "cytokine storm," and "coagulation," from January 2020-July 2022. Published data on pregnancy and COVID-19, and the interaction of the urogenital system and SARS-CoV-2 is reported. The immunologic and prothrombotic profiles of patients with COVID-19, and their increased risks from controlled ovarian stimulation (COS) and ART surgeries, and how these procedures could facilitate COVID-19 and/or contribute to the severity of the disease by enhancing the cytokine storm are summarized. Strategies to prevent complications during COS that could increase the risks of the disease in pre-symptomatic patients are considered. The impact of SARS-CoV-2 on pre-symptomatic infertile patients presents a challenge to find ways to avoid the increased hormonal, immunologic, and prothrombotic risks presented by the use of COS in ART protocols during the COVID-19 outbreak. Safe ART procedures and recommendations are highlighted.
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Affiliation(s)
- Marise Samama
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; GERA Institute of Reproductive Medicine, São Paulo, Brazil.
| | - Frida Entezami
- American Hospital of Paris, IVF Unit, Neuilly-Sur-Seine, France
| | - Daniela S Rosa
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Amanda Sartor
- GERA Institute of Reproductive Medicine, São Paulo, Brazil; Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
| | | | - Monica L Andersen
- Department of Psychobiology, Federal University of São Paulo, São Paulo, Brazil
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Mao Y, Yao Y, Du H, Wang Z, Zhou X, Zeng M, Wang C, Liu H, Luo Y, Hong H, Liu J, Li L. Effects of SARS-CoV-2 infection on embryological outcomes in assisted reproductive technology during the Omicron epidemic. J Ovarian Res 2023; 16:224. [PMID: 37993936 PMCID: PMC10664545 DOI: 10.1186/s13048-023-01301-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/24/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on assisted reproductive technology (ART) has received increasing attention. It has been reported that the SARS-CoV-2 RiboNucleic Acid (RNA) cannot be detected in follicular fluid and granulosa cells. However, the detection rate of SARS-CoV-2 RNA in immature oocytes and blastocysts has still unknown. Moreover, the effect of SARS-CoV-2 infection on embryological outcomes in ART during the Omicron epidemic is limited. METHODS A prospective study was performed to explore the detection rate of viral RNA in biological specimens from patients who tested positive for SARS-CoV-2 RNA and the effects of SARS-CoV-2 infection on embryological outcomes. A total of 211 patients underwent transvaginal oocyte retrieval at the Third Affiliated Hospital of Guangzhou Medical University between December 13, 2022 and December 30, 2022. Prior to transvaginal oocyte retrieval, 61 individuals tested positive for SARS-CoV-2 RNA within 24 h. Follicular fluid was preserved during oocyte retrieval. Granular cells were collected after degranulation (Intracytoplasmic sperm injection only). Immature oocytes were collected at the end of the ICSI. Unavailable blastocysts were collected on day 6 (D6). The TIANLONG SARS-CoV-2 RT-PCR-Kit was used to detect SARS-CoV-2 RNA in all samples. The COVID-19 and Non COVID-19 groups were contrasted in the following areas: fertilization rate, 2PN rate, Day 3 (D3) available embryos rate, D3 good-quality embryos rate, blastocyst formation rate, good-quality blastocyst formation rate. RESULTS All samples were negative except for an immature oocytes sample that was positive for SARS-CoV-2 viral RNA with a detection rate of 6.67%. Whether in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), the rate of fertilization, 2PN, D3 available embryos, D3 good-quality embryos, blastocyst formation, good-quality blastocyst formation was not significantly negative different between the COVID-19 and the Non COVID-19 groups. Our findings were validated by an overview of the embryological outcome from the cycles before SARS- Cov-2 infection from the same patient. CONCLUSIONS Except for immature oocytes, none of the follicular fluid, granulosa cells, or blastocysts samples contained viral RNA. In addition, SARS-CoV-2 infection had no detrimental effects on the embryological outcomes of ART.
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Affiliation(s)
- Yuling Mao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yachao Yao
- Department of Laboratory medicine, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Hongzi Du
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zheng Wang
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xueliang Zhou
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ming Zeng
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunyan Wang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hanyan Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yang Luo
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Honghai Hong
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jianqiao Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Lei Li
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
- Key Laboratory for Reproductive Medicine of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Xue Y, Xiong Y, Cheng X, Li K. Impact of SARS-CoV-2 infection on clinical outcomes of in vitro fertilization treatments: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1233986. [PMID: 37867530 PMCID: PMC10588479 DOI: 10.3389/fendo.2023.1233986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
The influence of SARS-CoV-2 infection on clinical outcomes in patients undergoing in vitro fertilization has been uncertain. Therefore, this systematic review and meta-analysis aimed to evaluate the impact of past SARS-CoV-2 infection on IVF outcomes. A comprehensive search of PubMed, EMBASE, and Cochrane Library databases was conducted from December 2019 to January 2023. Included studies comparing IVF outcomes between patients with prior SARS-CoV-2 infection and controls without previous infection were analyzed. Study quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Sensitivity analysis, publication bias, and heterogeneity were also examined. The review protocol was registered with PROSPERO (CRD42023392007). A total of eight studies, involving 317 patients with past SARS-CoV-2 infection and 904 controls, met the inclusion criteria. The meta-analysis revealed no significant differences between the infection group and controls in terms of clinical pregnancy rate (OR 0.97, 95% CI 0.73-1.29; P = 0.82), implantation rate (OR 0.99, 95% CI 0.67-1.46; P = 0.96), or miscarriage rate (OR 0.64, 95% CI 0.15-2.65; P = 0.53). Subgroup analyses based on transfer type demonstrated comparable clinical pregnancy rates between the two groups in both fresh embryo transfer (OR 0.97, 95% CI 0.69-1.36; P = 0.86) and frozen embryo transfer (OR 0.96, 95% CI 0.38-2.44; P = 0.94). In conclusion, this meta-analysis suggests that previous SARS-CoV-2 infection does not have a detrimental impact on clinical outcomes in IVF patients. These findings provide valuable insights into assessing the influence of prior SARS-CoV-2 infection on successful pregnancy outcomes in IVF treatment. The systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. This review was prospectively registered with the International Prospective Register of Systematic Reviews (ID CRD42023392007) on January 16, 2023.
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Affiliation(s)
- Yamei Xue
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuping Xiong
- School of Pharmacy, Hangzhou Medical College, Hangzhou, Zhejiang, China
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xiaohong Cheng
- School of Pharmacy, Hangzhou Medical College, Hangzhou, Zhejiang, China
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Kun Li
- School of Pharmacy, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Zhejiang Provincial Laboratory of Experimental Animal’s & Nonclinical Laboratory Studies, Hangzhou Medical College, Hangzhou, Zhejiang, China
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Huang J, Liu Y, Xia L, Zhao Y, Tian L, Xu D, Su Q, Hu Y, Xie Q, Chen J, Li Y, Ai X, Wang J, Wu Q. Effect of prior female SARS-CoV-2 infection on IVF outcomes: a prospective cohort study. Front Endocrinol (Lausanne) 2023; 14:1239903. [PMID: 37859985 PMCID: PMC10582695 DOI: 10.3389/fendo.2023.1239903] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction The clinical impact of SARS-CoV-2 infection on human reproduction remains controversial. This prospective cohort study aimed to assess the effect of prior female SARS-CoV-2 infection on subsequent in vitro fertilization (IVF) outcomes. Materials and methods A total of 451 women who underwent fresh IVF treatment between December 1, 2022 and April 30, 2023 were included from an academic fertility center. Participants were divided into the infected group if they had a prior COVID-19 history before cycle initiation (n = 252), while the control group were those uninfected (n = 199). The primary outcomes were the number of oocytes retrieved and clinical pregnancy rate after fresh embryo transfer. Multivariate linear and logistic regression analyses were conducted to control for potential confounders. Results The number of oocytes retrieved (11.4 ± 8.3 vs. 11.6 ± 7.7; P = 0.457) and clinical pregnancy rate (70.3% vs. 73.7%; P = 0.590) were similar between infected and uninfected groups, with a fully adjusted β coefficient of 0 (95% confidence interval [CI]: -0.14-0.13) and odds ratio of 0.64 (95% CI: 0.20-2.07), respectively. Consistently, the two groups were comparable in cycle characteristics as well as other laboratory and pregnancy parameters. In both subgroup analyses and restricted cubic splines, different post-infection time intervals to IVF cycle initiation showed no significant associations with treatment outcomes. Conclusion Prior SARS-CoV-2 infection in females had no adverse influence on subsequent IVF treatment, regardless of the time interval following infection. Our findings provide reassurance for infected women planning for assisted reproduction. Additional prospective cohort studies with larger datasets and longer follow-up are required to confirm the conclusion.
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Affiliation(s)
- Jialyu Huang
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Yuxin Liu
- Department of Clinical Medicine, School of Queen Mary, Nanchang University, Nanchang, China
| | - Leizhen Xia
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Yan Zhao
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Lifeng Tian
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Dingfei Xu
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Qiong Su
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Yina Hu
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Qiqi Xie
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Jia Chen
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Yunjun Li
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Xiaoyan Ai
- Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
| | - Jiawei Wang
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Qiongfang Wu
- Center for Reproductive Medicine, Jiangxi Key Laboratory of Women’s Reproductive Health, Jiangxi Maternal and Child Health Hospital, Jiangxi Branch of National Clinical Research Center for Obstetrics and Gynecology, Nanchang Medical College, Nanchang, China
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Wei L, Zhang J, Deng X, Luo C, Bo L, Gao S, Qian F, Lu S, Mao C. Impacts of the COVID-19 pandemic on Chinese assisted reproductive technology institutions and human sperm banks: reflections in the post-pandemic era. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:82. [PMID: 37592335 PMCID: PMC10436387 DOI: 10.1186/s41043-023-00422-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 07/21/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has been the most serious public health emergency encountered in modern assisted reproductive technology (ART) development. In order to identify lessons learned, this study reviews the effect of the pandemic on ART institutions and human sperm banks in China, and summarizes the experiences and reflections of Chinese scholars post-pandemic era. METHODS This review is based on multiple consensus statements on the COVID-19 pandemic issued by Chinese experts as well as current national regulations and principles in ART institutions and human sperm banks to document the current situation of ART services in China, describe the impact of the pandemic on these services, and offer Chinese reflections on worrying issues in the post-pandemic era. RESULTS China reached one million ART cycles in 2016, and there are currently 540 ART medical institutions and 27 human sperm banks, with 540 licensed for AIH, 91 for AID, 415 for conventional IVF and ICSI and 85 for PGT. Of these, only 4 institutions carry out 10,000 cycles or more annually, and the proportion of institutions with less than 1,000 cycles has reached 66%, which means that a considerable number of ART institutions are still not saturated. As a consequence of the COVID-19 pandemic, 63.6% of ART providers and 95.5% of human sperm banks suspended operations. By the end of May 2020, China, as an early country affected by the pandemic achieved a national resumption rate of ART medical services of 99.2% and that of human sperm banks of 100.0%. Reports from the first and largest human sperm bank in China showed that qualification, semen concentration and sperm viability rates measured at primary screening have significantly decreased post-pandemic. Much like in other countries, Chinese experts developed a consensus on prevention and control measures during the pandemic. In principle, all ART activities should be suspended during acute phases of infection spread. Chinese scholars highlight that attention should be paid to young patients with fertility requirements during and after COVID-19, and emphasize the importance of fertility evaluation and clinical intervention. In addition, couples should be reminded that during ART treatment, disinfectants should not be used excessively to minimize risks of damaging the reproductive system, gametes and zygotes. At the same time, timely and reasonable guidance for tackling negative emotions from stress response is needed to provide reassurance and to avoid irrational fear and excessive stress. Seminal parameters should be re-examined 2 months after SARS-CoV-2 vaccination, and ART treatments recommenced if no abnormalities are detected. CONCLUSIONS Given the growing frequency of outbreaks of global infectious diseases in recent years, ART institutions and human sperm banks should pay attention to improving their prevention and control capabilities. To a certain extent, decisions and measures adopted in China during COVID-19 pandemic are worthy of recognition and acceptance. Chinese scholars have discussed, proactively responded to and understand the key issues surrounding ART development during the pandemic with the aim of contributing to the substantial progress and healthy development of ART services in the world.
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Affiliation(s)
- Lun Wei
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Jiakai Zhang
- Centre for Chinese Urbanization Studies & Collaborative Innovation Center for New Urbanization and Social Governance of Universities in Jiangsu, Soochow University, No.50 Donghuan Road, Suzhou, 215021, Jiangsu, China
- Suzhou High School Affiliated to Xi'an Jiaotong University, Suzhou, Jiangsu, China
| | - Xiaoling Deng
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Chao Luo
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Le Bo
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Shasha Gao
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Fei Qian
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Shucheng Lu
- Centre for Chinese Urbanization Studies & Collaborative Innovation Center for New Urbanization and Social Governance of Universities in Jiangsu, Soochow University, No.50 Donghuan Road, Suzhou, 215021, Jiangsu, China.
| | - Caiping Mao
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China.
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Tian F, Li S, Li N, Zhao H, Luo M, Zhang J, Mao Z, Zhang Q, Li R, Tang T, Zhang C, Li Y, Zhang S, Zhao J. Association of SARS-CoV-2 Infection During Controlled Ovarian Stimulation With Oocyte- and Embryo-Related Outcomes. JAMA Netw Open 2023; 6:e2323219. [PMID: 37440229 PMCID: PMC10346123 DOI: 10.1001/jamanetworkopen.2023.23219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/29/2023] [Indexed: 07/14/2023] Open
Abstract
Importance SARS-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. Objective To investigate the association between SARS-CoV-2 infection during COS with oocyte- and embryo-related outcomes. Design, Setting, and Participants A 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. Exposure In 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 Measures Primary 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. Results A 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 Relevance In 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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Affiliation(s)
- Fen Tian
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Women’s Reproductive Health in Hunan Province, Changsha, Hunan, China
| | - Saijiao Li
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ning Li
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Zhao
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Women’s Reproductive Health in Hunan Province, Changsha, Hunan, China
| | - Man Luo
- Reproductive Medicine Center, Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China
| | - Jing Zhang
- Reproductive Medicine Center, The First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Zenghui Mao
- Reproductive Medicine Center, Changsha Hospital for Maternal & Child Health Care, Changsha, Hunan, China
| | - Qianjie Zhang
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rong Li
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Tingting Tang
- Reproductive Medicine Center, Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China
| | - Cuilian Zhang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yanping Li
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Women’s Reproductive Health in Hunan Province, Changsha, Hunan, China
| | - Shaodi Zhang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Jing Zhao
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Women’s Reproductive Health in Hunan Province, Changsha, Hunan, China
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12
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Pourmasumi S, Kounis NG, Naderi M, Hosseinisadat R, Khoradmehr A, Fagheirelahee N, Kouni SN, de Gregorio C, Dousdampanis P, Mplani V, Michalaki MA, Plotas P, Assimakopoulos S, Gogos C, Aidonidis G, Roditis P, Matsas N, Velissaris D, Calogiuri G, Hung MY, Koniari I. Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative Review. Balkan Med J 2023; 40:153-164. [PMID: 37114907 PMCID: PMC10175880 DOI: 10.4274/balkanmedj.galenos.2023.2023-3-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Several studies and research papers have been published to elucidate and understand the mechanism of the coronavirus disease 2019 (COVID-19) pandemic and its long-term effects on the human body. COVID-19 affects a number of organs, including the female reproductive system. However, less attention has been given to the effects of COVID-19 on the female reproductive system due to their low morbidity. The results of studies investigating the relationship between COVID-19 infection and ovarian function in women of reproductive age have shown the harmless involvement of COVID-19 infection. Several studies have reported the involvement of COVID-19 infection in oocyte quality, ovarian function, and dysfunctions in the uterine endometrium and the menstrual cycle. The findings of these studies indicate that COVID-19 infection negatively affects the follicular microenvironment and dysregulate ovarian function. Although the COVID-19 pandemic and female reproductive health have been studied in humans and animals, very few studies have examined how COVID-19 affects the female reproductive system. The objective of this review is to summarize the current literature and categorize the effects of COVID-19 on the female reproductive system, including the ovaries, uterus, and hormonal profiles. The effects on oocyte maturation, oxidative stress, which causes chromosomal instability and apoptosis in ovaries, in vitro fertilization cycle, high-quality embryos, premature ovarian insufficiency, ovarian vein thrombosis, hypercoagulable state, women’s menstrual cycle, the hypothalamus-pituitary-ovary axis, and sex hormones, including estrogen, progesterone, and the anti-Müllerian hormone, are discussed in particular.
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Affiliation(s)
- Soheila Pourmasumi
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nicholas G. Kounis
- Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, Patras, Greece
| | - Monavar Naderi
- Knowledge and Information Science, Vice Chancellor for Science and Technology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Robabe Hosseinisadat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Arezoo Khoradmehr
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Niloofar Fagheirelahee
- Department of Anatomy, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University of Messina Medical School, Messina, Italy
| | | | - Virginia Mplani
- Intensive Care Unit, Patras University Hospital, Patras, Greece
| | - Marina A. Michalaki
- Department of Internal Medicine, Division of Endocrinology, Fculty of Health Sciences, University of Patras, Patras, Greece
| | | | - Stelios Assimakopoulos
- Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Patras, Greece
| | - Christos Gogos
- COVID-19 Unit, Papageorgiou General Hospital, Thessaloniki, Greece
| | | | - Pavlos Roditis
- Department of Cardiology, Mamatsio Kozanis General Hospital, Kozani, Greece
| | | | | | - Gianfranco Calogiuri
- Pneumonology Department, Civil Hospital “Ninetto Melli”, Pietro Vernoti, Brindisi, Italy
- Department of Internal Medicine, Immunology and Infectious Diseases, Section of Allergology and Clinical Immunology, University of Bari Medical School, Bari, Italy
| | - Ming-Yow Hung
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
| | - Ioanna Koniari
- Departmentof Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
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Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
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Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey.,ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
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Chen X, Shi H, Li C, Zhong W, Cui L, Zhang W, Geng L, Hu K, Fang M, Wei D, Yan J, Sun Y, Wu K, Zhao H, Chen ZJ. The effect of SARS-CoV-2 infection on human embryo early development: a multicenter prospective cohort study. SCIENCE CHINA. LIFE SCIENCES 2023:10.1007/s11427-023-2291-0. [PMID: 36795183 PMCID: PMC9933004 DOI: 10.1007/s11427-023-2291-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Xiaolei Chen
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Huangcong Shi
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Cheng Li
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Wanxia Zhong
- Center for reproductive medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127 China ,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200127 China
| | - Linlin Cui
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China ,Center for Reproductive Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Wenjun Zhang
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Ling Geng
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China
| | - Kuona Hu
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China
| | - Mei Fang
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China
| | - Daimin Wei
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Junhao Yan
- Center for Reproductive Medicine, Shandong University, Jinan, 250012 China ,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012 China ,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012 China ,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012 China ,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012 China ,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012 China
| | - Yun Sun
- Center for reproductive medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200127, China.
| | - Keliang Wu
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, China. .,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, China. .,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China.
| | - Han Zhao
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, China. .,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, China. .,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China.
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong University, Jinan, 250012, China. .,Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy of Medical Sciences, Jinan, 250012, China. .,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, China. .,Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, China. .,National Research Center of Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, 250012, China. .,Center for reproductive medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200127, China.
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15
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Past COVID-19: The Impact on IVF Outcomes Based on Follicular Fluid Lipid Profile. Int J Mol Sci 2022; 24:ijms24010010. [PMID: 36613453 PMCID: PMC9820085 DOI: 10.3390/ijms24010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/12/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Follicular fluid is an important component of follicle growth and development. Negative effects of COVID-19 on follicular function are still open. The aim of this work was to study the features of the lipid profile of follicular fluid and evaluate the results of the in vitro fertilization (IVF) program in women after COVID-19 to identify biomarkers with prognostic potential. The study involved samples of follicular fluid collected from 237 women. Changes in the lipid composition of the follicular fluid of patients who underwent COVID-19 in mild and severe forms before entering the IVF program and women who did not have COVID-19 were studied by mass spectrometry. Several lipids were identified that significantly changed their level. On the basis of these findings, models were developed for predicting the threat of miscarriage in patients who had a severe course of COVID-19 and models for predicting the success of the IVF procedure, depending on the severity of COVID-19. Of practical interest is the possibility of using the developed predictive models in working with patients who have undergone COVID-19 before entering the IVF program. The results of the study suggest that the onset of pregnancy and its outcome after severe COVID-19 may be associated with changes in lipid metabolism in the follicular fluid.
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16
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de Miguel-Gómez L, Sebastián-León P, Romeu M, Pellicer N, Faus A, Pellicer A, Díaz-Gimeno P, Cervelló I. Endometrial gene expression differences in women with coronavirus disease 2019. Fertil Steril 2022; 118:1159-1169. [PMID: 36333264 PMCID: PMC9624514 DOI: 10.1016/j.fertnstert.2022.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To study the potential effect of coronavirus disease (COVID-19) on the endometrial transcriptome of affected, symptomatic women for the detection of altered gene expression. DESIGN Pilot study of the endometrial transcriptomes of women manifesting COVID-19 compared with those of women without COVID-19 undergoing hysteroscopic procedures for benign gynecologic disorders using RNA sequencing. SETTING Hospital and university laboratories. PATIENT(S) Women with (n = 14) and without a COVID-19 (n = 10) diagnosis based on a nasopharyngeal swab analysis using quantitative reverse-transcription polymerase chain reaction. The endometrium of the patients with COVID-19 had previously been tested for severe acute respiratory syndrome coronavirus 2 infection, revealing the absence of the virus in this tissue. INTERVENTION(S) Endometrial biopsy sample collection. MAIN OUTCOMES MEASURE(S) Endometrial gene expression and functional analysis of symptomatic patients with COVID-19 vs. individuals without the infection. RESULT(S) The systemic disease COVID-19 altered endometrial gene expression in 75% of the women, with the patients exhibiting a preponderance of 163 up-regulated (e.g., UTS2, IFI6, IFIH1, and BNIP3) and 72 down-regulated genes (e.g., CPZ, CDH3, and IRF4) (false discovery rate<0.05). A total of 161 dysregulated functions (36 up-regulated and 125 down-regulated) were typically enriched in the endometria of the patients with COVID-19, including up-regulation in pathways involved in the development of immune responses to viruses and cytokine inflammation, reflecting elicitation of a COVID-19 response pathway. CONCLUSION(S) Coronavirus disease 2019 affects endometrial gene expression despite the absence of severe acute respiratory syndrome coronavirus 2 RNA in endometrial tissues.
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Affiliation(s)
- Lucía de Miguel-Gómez
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, (b)Reproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Patricia Sebastián-León
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, (b)Reproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Mónica Romeu
- La Fe University Hospital, Valencia, Spain; Women's Health Area, Human Reproduction Unit, La Fe University Hospital, Valencia, Spain
| | - Nuria Pellicer
- La Fe University Hospital, Valencia, Spain; Women's Health Area, Human Reproduction Unit, La Fe University Hospital, Valencia, Spain
| | - Amparo Faus
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, (b)Reproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Pellicer
- Women's Health Area, Human Reproduction Unit, La Fe University Hospital, Valencia, Spain; Pediatrics, Obstetrics, and Gynecology Department, University of Valencia, Spain
| | - Patricia Díaz-Gimeno
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, (b)Reproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Irene Cervelló
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, (b)Reproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain.
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17
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Bhayana DP, Raja KA, Chitra J, Sonu B. Failure to Detect Viral Ribonucleic Acid in Follicular Fluid of a Severe Acute Respiratory Syndrome Coronavirus 2-Infected Female - A Report from the Indian Subcontinent. J Hum Reprod Sci 2022; 15:396-398. [PMID: 37033137 PMCID: PMC10077745 DOI: 10.4103/jhrs.jhrs_156_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 04/11/2023] Open
Abstract
Till today, we are still not clear about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on reproductive tissues and its vertical transmission through the gametes and embryos. There are few case reports that aim to detect the presence or absence of SARS-CoV-2 viral ribonucleic acid (RNA) in the follicular fluid of the infected females. We hereby present the case report of a 33-year-old woman who was undergoing intracytoplasmic sperm injection with testicular sperm aspiration and was found to be positive for SARS-CoV-2 infection. The follicular fluid analysis failed to detect the presence of viral RNA in the sample. Ours is the first case report from India trying to detect the viral RNA from the follicular fluid of a female with SARS-CoV-2 positive status.
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18
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Oocyte Retrieval in Asymptomatic Patients Positive for SARS-CoV-2. Case Rep Obstet Gynecol 2022; 2022:3107747. [PMID: 35990707 PMCID: PMC9391171 DOI: 10.1155/2022/3107747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Objective. To report two cases of oocyte retrieval performed in asymptomatic SARS-CoV-2-positive patients. Design. Case report. Setting. Outpatient private practice infertility center. Patients. A 28-year-old woman at risk for OHSS who took her trigger injection prior to testing positive for SARS-CoV-2 and a 19-year-old oncofertility patient who tested positive prior to retrieval due to a family exposure. Both patients were asymptomatic. Main Outcome Measures. Cycle outcomes, patient safety, and staff safety. Results. Both patients underwent successful oocyte retrieval procedures without developing symptoms or complications from COVID-19. No staff members that cared for these patients developed symptoms of COVID-19. Conclusion. Worsening fertility outcomes and potential for psychological and financial burdens to the patient must be balanced with risk of perioperative complications in patients testing positive for SARS-CoV-2. As we continue to provide fertility care in a world with COVID-19, appropriate risk mitigation strategies should be implemented to minimize exposure to SARS-CoV-2.
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19
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Clain E, Johnson J, Roeca C. Triggered with COVID: What are my chances, Doc? Fertil Steril 2022; 117:781-782. [PMID: 35277260 PMCID: PMC8902896 DOI: 10.1016/j.fertnstert.2022.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/04/2022]
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