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González M, Al-Adib M, Rodríguez AB, Carrasco C. COVID-19 and menstrual-related disturbances: a Spanish retrospective observational study in formerly menstruating women. Front Glob Womens Health 2024; 5:1393765. [PMID: 39140011 PMCID: PMC11319254 DOI: 10.3389/fgwh.2024.1393765] [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: 02/29/2024] [Accepted: 07/16/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction Four years after the start of the pandemic, there is limited evidence on the impact of COVID-19 on the women's health regardless of their reproductive status. Objective The aim was to analyze the prevalence and associated factors of menstrual-related disturbances in formerly menstruating women following SARS-CoV-2 infection. Study design A retrospective observational study of adult women in Spain was conducted during the month of December 2021 using an online survey (N = 17,512). The present analysis includes a subpopulation of SARS-CoV-2-infected and formerly menstruating women (n = 72). The collected data included general characteristics, medical history, and specific information on COVID-19. Chi-square and Mann-Whitney U-tests were performed. Bivariate logistic regression analysis was then performed to investigate possible associations between the occurrence of menstrual-related disturbances after SARS-CoV-2 infection. Results 38.8% of participants experienced menstrual-related disturbances following COVID-19. Among these, unexpected vaginal bleeding (20.8%) was the most common event, followed by spotting (11.1%) ( Table 1). Other reported changes were in the length (shorter = 12.5%) and flow (heavier = 30.3%) of menstrual bleeding in comparison to their previous experience. Regression analysis revealed that being a perimenopausal woman [adjusted odds ratio (AOR) 4.721, CI 95%, 1.022-21.796, p = 0.047] and having a previous diagnosis of menorrhagia (AOR 5.824 CI 95%, 1.521-22.310, p = 0.010) were factors associated with the event. Conclusion These findings could help health professionals provide their patients with up-to-date scientific information to empower them to actively manage their reproductive health, especially in societies where menstrual health is still taboo.
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Affiliation(s)
- María González
- Grupo de investigación Neuroinmunofisiología y Crononutrición, Departamento de Fisiología, Universidad de Extremadura, Badajoz, Spain
| | - Miriam Al-Adib
- Grupo de investigación Neuroinmunofisiología y Crononutrición, Departamento de Fisiología, Universidad de Extremadura, Badajoz, Spain
- Obstetrics & Gynecology Clinics “Miriam Gine”, Badajoz, Spain
| | - Ana B. Rodríguez
- Grupo de investigación Neuroinmunofisiología y Crononutrición, Departamento de Fisiología, Universidad de Extremadura, Badajoz, Spain
| | - Cristina Carrasco
- Grupo de investigación Neuroinmunofisiología y Crononutrición, Departamento de Fisiología, Universidad de Extremadura, Badajoz, Spain
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2
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Deogade MS, Tahlan N, Anjum S, Parwati, Jena S, Bhati D, Acharyya A, Nesari TM. Dysmenorrhea and heavy bleeding as complications in COVID-19-positive women: An observational study. J Family Med Prim Care 2023; 12:1849-1853. [PMID: 38024926 PMCID: PMC10657055 DOI: 10.4103/jfmpc.jfmpc_1988_22] [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: 10/08/2022] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 12/01/2023] Open
Abstract
Immunological dysregulation and inflammation may play a role in the nature of menstruation. Coronavirus disease 2019 (COVID-19) can produce a systemic inflammatory reaction that involves extrapulmonary organs and can also affect the immune system. This study aimed to analyze changes in the menstrual cycle in coronavirus (COVID)-positive women of reproductive age. Methods The data of 35 women of reproductive age were collected telephonically from said patients admitted to the COVID Health Centre (CHC) ward of All India Institute of Ayurveda, New Delhi, during June 20, 2020, to October 31, 2020. Purposive sampling was used for data collection. Wyatt menstrual pictogram and Visual Analogue Scale (VAS) were used to assess the bleeding pattern and pain during menstruation, respectively. Results Clinically, changes were noted in post-COVID menstruation such as irregularity, polymenorrhea, oligomenorrhea, clots, and menstrual flow in days. However, all results were statistically non-significant. But significant (P = 0.003) menstrual pain was reported. Conclusion Menstrual changes were observed in COVID-19-positive women belonging to the reproductive age group.
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Affiliation(s)
- Meena Shamrao Deogade
- Department of Dravyaguna (Ayurveda Pharmacology), All India Institute of Ayurveda, Gautampuri, New Delhi, India
| | - Nidhi Tahlan
- Department of Stree Roga and Prasuti Tanta (Gynecology), All India Institute of Ayurveda, Gautampuri, New Delhi, India
| | - Sadaf Anjum
- Department of Stree Roga and Prasuti Tanta (Gynecology), All India Institute of Ayurveda, Gautampuri, New Delhi, India
| | - Parwati
- Department of Panchakarma, All India Institute of Ayurveda, Gautampuri, New Delhi, India
| | - Swarnakant Jena
- Department of Panchakarma, All India Institute of Ayurveda, Gautampuri, New Delhi, India
| | - Deepak Bhati
- Senior Medical Officer and Casualty Head, All India Institute of Ayurveda, Gautampuri, New Delhi, India
| | - Amitava Acharyya
- Scheme Section (Ayush and Public Health Component of Ayurswasthya Yojana), Ministry of AYUSH, Government of India, New Delhi, India
| | - Tanuja Manoj Nesari
- Department of Dravyaguna (Ayurveda Pharmacology), All India Institute of Ayurveda, Gautampuri, New Delhi, India
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3
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Błażejewski G, Witkoś J. The Impact of COVID-19 on Menstrual Cycle in Women. J Clin Med 2023; 12:4991. [PMID: 37568393 PMCID: PMC10419606 DOI: 10.3390/jcm12154991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has become the largest and most diverse to threaten the health of humanity since the 1918 influenza pandemic. METHODS This study involved 113 women who had suffered from COVID-19. The study was conducted as interviews with each woman during visits to a clinic prior to the start of their post-COVID-19 physiotherapy treatment cycle. The aim of this study was to assess the prevalence of changes in the women's monthly cycles related to COVID-19, as well as to analyse correlations between dependent variables relating to changes in the monthly cycle and independent variables relating to other factors, such as age, weight, number and type of vaccinations, and time since illness. Additionally, the study assesses correlations between the monthly cycle and COVID-19 symptoms persisting after the illness (long COVID). RESULTS Women who reported more symptoms of COVID-19 were more likely to report changes in their menstrual cycle occurring after the SARS-CoV-2 infection, compared with women whose disease course was mild. Women who declared that COVID-19 affected their monthly cycles most often indicated increases in abdominal, lower abdominal, and joint and muscle pain, as well as in the severity of headaches during monthly bleeding. A small percentage of women indicated that their monthly cycles were longer and their regularity disrupted. CONCLUSIONS This study shows that the more COVID-19 symptoms a woman had, the more often there were noted changes in monthly cycle. The same relationship was also found for persistent long COVID symptoms. The longer the time lapse since the COVID-19 infection, the less frequently changes in the monthly cycle were recorded.
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Affiliation(s)
- Grzegorz Błażejewski
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, G. Herlinga-Grudzińskiego, Street 1, 30-705 Kraków, Poland
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4
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Abstract
The COVID-19 pandemic has had a profound global impact, affecting people's physical and mental health, and their social and economic circumstances. Mitigation measures have disproportionately affected women. Studies have reported menstrual cycle and psychological disturbance associated with the pandemic. Pregnancy is a risk factor for severe COVID-19 disease. Reports have also demonstrated associations between COVID-19 infection, vaccination and Long COVID syndrome and reproductive health disturbance. However, studies are limited and there may be significant geographical variation. Also there is bias amongst published studies, and menstrual cycle data was not included in COVID-19 and vaccine trials. Longitudinal population based studies are required. In this review we discuss existing data, along with recommendations for further research required in this area. We also discuss a pragmatic approach to women presenting with reproductive health disturbance in the era of the pandemic, encompassing a multi-system assessment of psychological, reproductive health and lifestyle.
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Affiliation(s)
- Michelle Maher
- Department of Endocrinology, St James's Hospital, Dublin, Ireland; Department of Medicine, Trinity College Dublin, Ireland
| | - Lisa Owens
- Department of Endocrinology, St James's Hospital, Dublin, Ireland; Department of Medicine, Trinity College Dublin, Ireland.
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5
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Issakov G, Tzur Y, Friedman T, Tzur T. Abnormal Uterine Bleeding Among COVID-19 Vaccinated and Recovered Women: a National Survey. Reprod Sci 2023; 30:713-721. [PMID: 35986194 PMCID: PMC9390105 DOI: 10.1007/s43032-022-01062-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/04/2022] [Indexed: 11/05/2022]
Abstract
The objective of this research was to characterize menstrual changes including amount, duration, and frequency among COVID-19 vaccinated and infected women. We conducted an online nationwide questionnaire survey on premenopausal, non-pregnant women over 18 years of age in Israel, querying about any changes in their menstrual patterns after COVID-19 vaccination or infection. In total, 10,319 women responded, of which 7904 met the inclusion criteria. Changes in menstrual patterns following COVID-19 vaccination or infection were reported in 3689/7476 (49.3%) women compared with 202/428 (47.2%) women, respectively, (P = .387). The most commonly described menstrual disturbance was excessive bleeding (heavy, prolonged, or intermenstrual) in both the vaccinated and infected groups, (80.6% versus 81.4%, respectively, P = .720). Among women who experienced abnormal uterine bleeding (AUB), in most cases (61.1%), it occurred between the vaccination and the ensuing menstrual period. Menstrual disturbances were similar in type among the vaccinated and infected women. In conclusion, AUB emerged as a side effect of the BNT162b2 vaccine and a symptom of the COVID-19 infection and was characterized mainly by excessive bleeding. Although the precise incidence could not be determined in this study, the type of bleeding disorder as well as the characterization of risk factors including increasing age and a baseline menstrual pattern of prolonged, frequent, and heavy menses are well defined. The incidence and the long-term consequences of the BNT162b2 vaccine on uterine bleeding warrant further investigation.
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Affiliation(s)
- Gal Issakov
- Obstetrics Gynecology and IVF Department, Laniado Medical Center, Netanya, Israel.
- Adelson Medical School, Ariel University, Ariel, Israel.
| | - Yossi Tzur
- Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Talia Friedman
- Obstetrics Gynecology and IVF Department, Laniado Medical Center, Netanya, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Obstetrics and Gynecology, Sheba Medical Center Tel Hashomer, Ramat Gan, Israel
| | - Tamar Tzur
- Adelson Medical School, Ariel University, Ariel, Israel
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6
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Wang S, Mortazavi J, Hart JE, Hankins JA, Katuska LM, Farland LV, Gaskins AJ, Wang YX, Tamimi RM, Terry KL, Rich-Edwards JW, Missmer SA, Chavarro JE. A prospective study of the association between SARS-CoV-2 infection and COVID-19 vaccination with changes in usual menstrual cycle characteristics. Am J Obstet Gynecol 2022; 227:739.e1-739.e11. [PMID: 35841938 PMCID: PMC9277995 DOI: 10.1016/j.ajog.2022.07.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite anecdotal reports, the impacts of SARS-CoV-2 infection or COVID-19 vaccination on menstrual health have not been systemically investigated. OBJECTIVE This study aimed to examine the associations of SARS-CoV-2 infection and COVID-19 vaccination with menstrual cycle characteristics. STUDY DESIGN This study prospectively observed 3858 premenopausal women in the Nurses' Health Study 3 living in the United States or Canada who received biannual follow-up questionnaires between January 2011 and December 2021 and completed additional monthly and quarterly surveys related to the COVID-19 pandemic between April 2020 and November 2021. History of positive SARS-CoV-2 test, COVID-19 vaccination status, and vaccine type were self-reported in surveys conducted in 2020 and 2021. Current menstrual cycle length and regularity "before COVID-19" were reported at baseline between 2011 and 2016, and current menstrual cycle length and regularity "after COVID-19" were reported in late 2021. Pre- to post-COVID change in menstrual cycle length and regularity was calculated between reports. Logistic or multinomial logistic regression models were used to assess the associations between SARS-CoV-2 infection and COVID-19 vaccination and change in menstrual cycle characteristics. RESULTS The median age at baseline and the median age at end of follow-up were 33 years (range, 21-51) and 42 years (range, 27-56), respectively, with a median follow-up time of 9.2 years. This study documented 421 SARS-CoV-2 infections (10.9%) and 3527 vaccinations (91.4%) during follow-up. Vaccinated women had a higher risk of increased cycle length than unvaccinated women (odds ratio, 1.48; 95% confidence interval, 1.00-2.19), after adjusting for sociodemographic and behavioral factors. These associations were similar after in addition accounting for pandemic-related stress. COVID-19 vaccination was only associated with change to longer cycles in the first 6 months after vaccination (0-6 months: odds ratio, 1.67 [95% confidence interval, 1.05-2.64]; 7-9 months: odds ratio, 1.43 [95% confidence interval, 0.96-2.14]; >9 months: odds ratio, 1.41 [95% confidence interval, 0.91-2.18]) and among women whose cycles were short, long, or irregular before vaccination (odds ratio, 2.82 [95% confidence interval, 1.51-5.27]; odds ratio, 1.10 [95% confidence interval, 0.68-1.77] for women with normal length, regular cycles before vaccination). Messenger RNA and adenovirus-vectored vaccines were both associated with this change. SARS-CoV-2 infection was not associated with changes in usual menstrual cycle characteristics. CONCLUSION COVID-19 vaccination may be associated with short-term changes in usual menstrual cycle length, particularly among women whose cycles were short, long, or irregular before vaccination. The results underscored the importance of monitoring menstrual health in vaccine clinical trials. Future work should examine the potential biological mechanisms.
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Affiliation(s)
- Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jasmine Mortazavi
- Department of Obstetrics, Gynecology, and Reproductive Biologym, Michigan State University College of Human Medicine, Grand Rapids, MI
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jennifer A Hankins
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Laura M Katuska
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yi-Xin Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Rulla M Tamimi
- Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Kathryn L Terry
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Stacey A Missmer
- Department of Obstetrics, Gynecology, and Reproductive Biologym, Michigan State University College of Human Medicine, Grand Rapids, MI; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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7
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Koc HC, Xiao J, Liu W, Li Y, Chen G. Long COVID and its Management. Int J Biol Sci 2022; 18:4768-4780. [PMID: 35874958 PMCID: PMC9305273 DOI: 10.7150/ijbs.75056] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/22/2022] [Indexed: 12/12/2022] Open
Abstract
The pandemic of COVID-19 is the biggest public health crisis in 21st Century. Besides the acute symptoms after infection, patients and society are also being challenged by the long-term health complications associated with COVID-19, commonly known as long COVID. While health professionals work hard to find proper treatments, large amount of knowledge has been accumulated in recent years. In order to deal with long COVID efficiently, it is important for people to keep up with current progresses and take proactive actions on long COVID. For this purpose, this review will first introduce the general background of long COVID, and then discuss its risk factors, diagnostic indicators and management strategies. This review will serve as a useful resource for people to understand and prepare for long COVID that will be with us in the foreseeable future.
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Affiliation(s)
- Ho Cheng Koc
- Centre of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China
| | - Jing Xiao
- Centre of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Interventional Medical Centre, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai 519000, China
| | - Weiwei Liu
- Centre of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Bioimaging and Stem Cell Core Facility, Faculty of Health Sciences, University of Macau, Taipa, Macau, China
| | - Yong Li
- Interventional Medical Centre, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai 519000, China
| | - Guokai Chen
- Centre of Reproduction, Development & Aging, Faculty of Health Sciences, University of Macau, Taipa, Macau, China.,Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China
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8
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Lebar V, Laganà AS, Chiantera V, Kunič T, Lukanović D. The Effect of COVID-19 on the Menstrual Cycle: A Systematic Review. J Clin Med 2022; 11:jcm11133800. [PMID: 35807090 PMCID: PMC9267255 DOI: 10.3390/jcm11133800] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/19/2022] [Accepted: 06/28/2022] [Indexed: 01/17/2023] Open
Abstract
Researchers have been studying COVID-19 from day one, but not much is known about the impact of COVID-19 on the reproductive system, specifically the female reproductive system. There has been substantial anecdotal and media coverage on the effect of COVID-19 on the female reproductive system and changes in the menstrual cycle, but so far available data are not robust enough to draw firm conclusions about the topic. This article was carried out to present already published studies on the correlation between SARS-CoV-2 infection and menstrual cycle changes. A systematic literature search was conducted on the Medline, Scopus, and Cochrane Library databases in accordance with the PRISMA guidelines. Three studies were finally included in the review. The findings of the studies indicate changes in menstrual volume and changes in menstrual cycle length as consequences of SARS-CoV-2 infection; the latter was also the most common menstrual irregularity reported by the included studies. Women have mainly reported decreased menstrual volume and a prolonged cycle. The findings also indicate that the severity of COVID-19 does not play a role in menstrual cycle changes. However, the research on this topic is still too scarce to draw definitive conclusions, and there is a need for further research. The relevant conclusions, which could be drawn only from a well-constructed study, would have a major effect on defining the impact of SARS-CoV-2 infection on the menstrual cycle.
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Affiliation(s)
- Vojka Lebar
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.S.L.); (V.C.)
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (A.S.L.); (V.C.)
| | - Tina Kunič
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana Medical Center, Zaloška 2, 1000 Ljubljana, Slovenia;
| | - David Lukanović
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana Medical Center, Zaloška 2, 1000 Ljubljana, Slovenia;
- Correspondence: ; Tel.: +38-615-226-005
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9
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Shemies RS, El‐Gilany A, Sayed‐Ahmed N, Megahed AF, El‐Behnasawy HM, Farouk HN, Saad HH, El‐Anwar MH, Gaber T. Amenorrhea, premenstrual tension syndrome, and dysmenorrhea among women of reproductive age on hemodialysis: A national study in Egypt. Semin Dial 2022; 35:348-357. [DOI: 10.1111/sdi.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/14/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Rasha Samir Shemies
- Mansoura Nephrology and Dialysis Unit, Faculty of Medicine Mansoura University Mansoura Egypt
| | - Abdel‐Hady El‐Gilany
- Community Medicine Department, Faculty of Medicine Mansoura University Mansoura Egypt
| | - Nagy Sayed‐Ahmed
- Mansoura Nephrology and Dialysis Unit, Faculty of Medicine Mansoura University Mansoura Egypt
| | | | | | | | - Hany Helmy Saad
- Nephrology and Dialysis Unit Shobra General Hospital Cairo Egypt
| | | | - Tamer Gaber
- Mansoura Nephrology and Dialysis Unit, Faculty of Medicine Mansoura University Mansoura Egypt
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10
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Carbone L, Conforti A, La Marca A, Cariati F, Vallone R, Raffone A, Buonfantino C, Palese M, Mascia M, DI Girolamo R, Capuzzo M, Esteves SC, Alviggi C. The negative impact of most relevant infections on fertility and assisted reproduction technology. Minerva Obstet Gynecol 2022; 74:83-106. [PMID: 34137567 DOI: 10.23736/s2724-606x.21.04870-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infections may act with variable impact on the physiopathology of the reproductive organs, determining infertility or reducing the outcomes of assisted reproduction technology. The aim of this narrative review is to describe the existing evidence regarding the pathogens with a supposed or recognized role in reproductive medicine. Viral hepatitis, as well as HIV, can reduce sperm quality. Syphilis carries a risk of erectile dysfunction and increased endometrial thickness. Chlamydia is the main cause of pelvic inflammatory disease. In relation to Mycoplasma and Ureaplasma spp., only few species seem to show a correlation with infertility and poor in-vitro fertilization outcomes. There is evidence of a role for bacterial vaginosis in early pregnancy loss. HPV infection in males seems to determine infertility. Herpesviruses are more a risk for fetuses than for fertility itself. Zika virus is responsible for altered early embryo development and waiting to conceive is recommended in suspected or confirmed cases. The impact of SARS-CoV-2 is yet to be elucidated. Rubella and toxoplasmosis can provoke important congenital defects and therefore screening is mandatory before conception; a vaccine for Rubella is recommended. Further and well-designed studies are still needed to better elucidate the role of some infectious agents, to improve fertility and its treatments.
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Affiliation(s)
- Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy -
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Antonio La Marca
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Roberta Vallone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Cira Buonfantino
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Michela Palese
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Marika Mascia
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Raffaella DI Girolamo
- Center for High-Risk Pregnancy and Fetal Care, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Martina Capuzzo
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Sandro C Esteves
- Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil
- Faculty of Health, Aarhus University, Aarhus, Denmark
- ANDROFERT - Andrology and Human Reproduction Clinic, Campinas, Brazil
| | - Carlo Alviggi
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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11
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Kolanska K, Hours A, Jonquière L, Mathieu d'Argent E, Dabi Y, Dupont C, Touboul C, Antoine JM, Chabbert-Buffet N, Daraï E. Mild COVID-19 infection does not alter the ovarian reserve in women treated with ART. Reprod Biomed Online 2021; 43:1117-1121. [PMID: 34711516 PMCID: PMC8432972 DOI: 10.1016/j.rbmo.2021.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 12/13/2022]
Abstract
Research question Does mild COVID-19 infection affect the ovarian reserve of women undergoing an assisted reproductive technology (ART) protocol? Design A prospective observational study was conducted between June and December 2020 at the ART unit of Tenon Hospital, Paris. Women managed at the unit for fertility issues by in-vitro fecundation, intracytoplasmic sperm injection (IVF/ICSI), fertility preservation, frozen embryo transfer or artificial insemination, and with an anti-Müllerian hormone (AMH) test carried out within 12 months preceding ART treatment, were included. All the women underwent a COVID rapid detection test (RDT) and AMH concentrations between those who tested positive (RDT positive) and those who tested negative (RDT negative). Results The study population consisted of 118 women, 11.9% (14/118) of whom were COVID RDT positive. None of the tested women presented with a history of severe COVID-19 infection. The difference between the initial AMH concentration and AMH concentration tested during ART treatment was not significantly different between the COVID RDT positive group and COVID RDT negative group (–1.33 ng/ml [–0.35 to –1.61) versus –0.59 ng/ml [–0.15 to –1.11], P = 0.22). Conclusion A history of mild COVID-19 infection does not seem to alter the ovarian reserve as evaluated by AMH concentrations. Although these results are reassuring, further studies are necessary to assess the effect of COVID-19 on pregnancy outcomes in women undergoing ART.
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Affiliation(s)
- Kamila Kolanska
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, PARIS cedex 12 75571, France.
| | - Alice Hours
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France
| | - Laurie Jonquière
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France
| | - Emmanuelle Mathieu d'Argent
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France
| | - Yohann Dabi
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France
| | - Charlotte Dupont
- INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, PARIS cedex 12 75571, France; Service de biologie de la reproduction-CECOS, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France
| | - Cyril Touboul
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, PARIS cedex 12 75571, France
| | - Jean-Marie Antoine
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France
| | - Nathalie Chabbert-Buffet
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, PARIS cedex 12 75571, France
| | - Emile Daraï
- Service de gynécologie obstétrique et médecine de la reproduction, Hôpital Tenon, AP-HP, Sorbonne Université, 4 rue de la Chine, Paris 75020, France; INSERM UMRS 938, Centre de Recherche Saint-Antoine, 27 rue Chaligny, PARIS cedex 12 75571, France
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Cantalloube A, Ferraretto X, Lepage J, Gervais A, Llabador MA, Epelboin S. [Outcomes of cumulative transfers of fresh and frozen embryos in in vitro fertilization in women infected by hepatitis B virus]. ACTA ACUST UNITED AC 2021; 49:529-537. [PMID: 33434753 DOI: 10.1016/j.gofs.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the impact of hepatitis B virus (HBV) infection in women on in vitro fertilization (IVF) outcomes. METHODS An observational monocentric case-control cohort study conducted between 2012 and 2019 compared the outcomes of the first cycle of IVF between 64 woman infected with HBV and 128 seronegative controls. Frozen embryos transfers made within 18 months of the puncture were included. The exclusion criteria were severe infections, viral co-infection in women, any viral infection in their spouse, or lack of fresh embryo transfer. The matching was performed according to age, primary infertility or secondary, conventional or intracytoplasmic injection IVF technique and date of attempt. The main analysis focused on cumulative live births rates (LBR). RESULTS The clinical and ovarian stimulation characteristics were comparable except for a longer period of infertility in the HBV group. The LBR in the HBV group, when compared to controls, was not different after transfer of fresh (14.06 vs. 25.00% P=0.08) or frozen embryos (4.17 vs. 18.92% P=0.08), but significantly decreased in cumulative analysis (15.63 vs. 35.94% P=0.003). HBV infection was negatively associated with LBR in multivariate analysis OR=0.38 (95% CI 0.14-0.92) P<0.05. The implantation rate was lower in the HBV group versus controls, in fresh (14.89 vs. 27.72% P=0.02) and frozen (3.03 vs. 21.65% P=0.01) embryo transfers. CONCLUSION This study suggests a negative impact of HBV infection in women on the cumulative LBR after IVF.
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Affiliation(s)
- A Cantalloube
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, Nord-université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France.
| | - X Ferraretto
- Service de biologie de la reproduction, Nord-université de Paris, hôpital Bichat-Claude-Bernard, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - J Lepage
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, Nord-université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - A Gervais
- Service hépato gastro-entérologie, hôpital Bichat-Claude-Bernard, Nord-université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - M-A Llabador
- Service de biologie de la reproduction, Nord-université de Paris, hôpital Bichat-Claude-Bernard, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - S Epelboin
- Unité de médecine de la reproduction, service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, Nord-université de Paris, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
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Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, Lee S, Wang C, Li H, Cheng L, Ai J. Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reprod Biomed Online 2020; 42:260-267. [PMID: 33288478 PMCID: PMC7522626 DOI: 10.1016/j.rbmo.2020.09.020] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/06/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023]
Abstract
RESEARCH QUESTION Does SARS-CoV-2 infection have an effect on ovarian reserve, sex hormones and menstruation of women of child-bearing age? DESIGN This is a retrospective, cross-sectional study in which clinical and laboratory data from 237 women of child-bearing age diagnosed with COVID-19 were retrospectively reviewed. Menstrual data from 177 patients were analysed. Blood samples from the early follicular phase were tested for sex hormones and anti-Müllerian hormone (AMH). RESULTS Among 237 patients with confirmed COVID-19, severely ill patients had more comorbidities than mildly ill patients (34% versus 8%), particularly for patients with diabetes, hepatic disease and malignant tumours. Of 177 patients with menstrual records, 45 (25%) patients presented with menstrual volume changes, and 50 (28%) patients had menstrual cycle changes, mainly a decreased volume (20%) and a prolonged cycle (19%). The average sex hormone and AMH concentrations of women of child-bearing age with COVID-19 were not different from those of age-matched controls. CONCLUSIONS Average sex hormone concentrations and ovarian reserve did not change significantly in COVID-19 women of child-bearing age. Nearly one-fifth of patients exhibited a menstrual volume decrease or cycle prolongation. The menstruation changes of these patients might be the consequence of transient sex hormone changes caused by suppression of ovarian function that quickly resume after recovery.
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Affiliation(s)
- Kezhen Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Ge Chen
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Hongyan Hou
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Qiuyue Liao
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Jing Chen
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Hualin Bai
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Shiyeow Lee
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Cheng Wang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China
| | - Huijun Li
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China.
| | - Liming Cheng
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China.
| | - Jihui Ai
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei, China.
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