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Iranifard E, Yas A, Mansouri Ghezelhesari E, Taghipour A, Mahmoudinia M, Latifnejad Roudsari R. Treatment suspension due to the coronavirus pandemic and mental health of infertile patients: a systematic review and meta-analysis of observational studies. BMC Public Health 2024; 24:174. [PMID: 38218778 PMCID: PMC10787415 DOI: 10.1186/s12889-023-17628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/31/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Access to fertility treatments is considered a reproductive right, but because of the quarantine due to the coronavirus pandemic most infertility treatments were suspended, which might affect the psychological and emotional health of infertile patients. Therefore, this study was conducted to review the mental health of infertile patients facing treatment suspension due to the coronavirus pandemic. METHODS This study was conducted based on the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guideline. The Web of Science, PubMed, Embase, Scopus, and Cochrane library databases were searched by two independent researchers, without time limitation until 31 December 2022. All observational studies regarding the mental health of infertile patients facing treatment suspension including anxiety, depression, and stress were included in the study. Qualitative studies, editorials, brief communications, commentaries, conference papers, guidelines, and studies with no full text were excluded. Quality assessment was carried out using Newcastle-Ottawa Scale by two researchers, independently. The random effects model was used to estimate the pooled prevalence of mental health problems. Meta-regression and subgroup analysis were used to confirm the sources of heterogeneity. RESULTS Out of 681 studies, 21 studies with 5901 infertile patients were systematically reviewed, from which 16 studies were included in the meta-analysis. The results of all pooled studies showed that the prevalence of anxiety, depression, and stress in female patients was 48.4% (95% CI 34.8-62.3), 42% (95% CI 26.7-59.4), and 55% (95% CI 45.4-65), respectively. Additionally, 64.4% (95% CI 50.7-76.1) of patients wished to resume their treatments despite the coronavirus pandemic. CONCLUSION Treatment suspension due to the coronavirus pandemic negatively affected the mental health of infertile patients. It is important to maintain the continuity of fertility care, with special attention paid to mental health of infertile patients, through all the possible measures even during a public health crisis.
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Affiliation(s)
- Elnaz Iranifard
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Yas
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Taghipour
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Mahmoudinia
- Maternal and Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Carbone L, Raffone A, Travaglino A, Saccone G, Di Girolamo R, Neola D, Castaldo E, Iorio GG, Pontillo M, Arduino B, D'Alessandro P, Guida M, Mollo A, Maruotti GM. The impact of COVID-19 pandemic on obstetrics and gynecology hospitalization rate and on reasons for seeking emergency care: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2023; 36:2187254. [PMID: 36894183 DOI: 10.1080/14767058.2023.2187254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
BACKGROUND During the lockdown due to COVID-19 pandemic, utilization of emergency care units has been reported to be reduced for obstetrical and gynaecological reasons. The aim of this systematic review is to assess if this phenomenon reduced the rate of hospitalizations for any reason and to evaluate the main reasons for seeking care in this subset of the population. METHODS The search was conducted using the main electronic databases from January 2020 to May 2021. The studies were identified with the use of a combination of: "emergency department" OR "A&E" OR "emergency service" OR "emergency unit" OR "maternity service" AND "COVID-19" OR "COVID-19 pandemic" OR "SARS-COV-2" and "admission" OR "hospitalization". All the studies that evaluated women going to obstetrics & gynecology emergency department (ED) during the COVID-19 pandemic for any reason were included. RESULTS The pooled proportion (PP) of hospitalizations increased from 22.7 to 30.6% during the lockdown periods, in particular from 48.0 to 53.9% for delivery. The PP of pregnant women suffering from hypertensive disorders increased (2.6 vs 1.2%), as well as women having contractions (52 vs 43%) and rupture of membranes (12.0 vs 9.1%). Oppositely, the PP of women having pelvic pain (12.4 vs 14.4%), suspected ectopic pregnancy (1.8 vs 2.0), reduced fetal movements (3.0 vs 3.3%), vaginal bleeding both for obstetrical (11.7 vs 12.8%) and gynecological issues (7.4 vs 9.2%) slightly reduced. CONCLUSION During the lockdown, an increase in the proportion of hospitalizations for obstetrical and gynecological reasons has been registered, especially for labor symptoms and hypertensive disorders.
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Affiliation(s)
- Luigi Carbone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Raffaella Di Girolamo
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Daniele Neola
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Emanuele Castaldo
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Giuseppe Gabriele Iorio
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Martina Pontillo
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Bruno Arduino
- Maternal-Child Department, AOU Federico II hospital, Naples, Italy
| | | | - Maurizio Guida
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Giuseppe Maria Maruotti
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
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Lizán Tudela C, Cuevas Sáiz I, Abad de Velasco L, Gregori Navarro L, Comellas M, Pérez-Sádaba FJ, Lizán L. The Perspective of Patients and Health Professionals on the Prioritization of Assisted Reproductive Techniques. The PRIOFER Study. Patient Prefer Adherence 2023; 17:2641-2653. [PMID: 37927341 PMCID: PMC10624199 DOI: 10.2147/ppa.s421041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose To determine the perspective of patients and professionals in Assisted Reproduction Units (ARU) on the importance of assisted reproductive techniques (ART) compared to other elective procedures, to highlight the relevance of ART as an elective procedure and the impact of delayed interventions on patients. Design Patients and Methods An observational, descriptive, cross-sectional, online survey-based study was conducted in infertility patients and partners (n=98) and ARU healthcare professionals (n=83). The survey included a best-worst scaling (BWS) experiment and an ad-hoc questionnaire to analyze the pandemic impact on ART management and infertility patients in Spain. In the BWS, each respondent established priorities choosing which patient profile should be rated as the highest and lowest priority profile on a waiting list. To understand the importance that they give to assisted reproduction compared to other procedures, three very common elective procedures involving different patient profiles were selected: cataract surgery, knee arthroplasty, and varicose vein surgery. For each procedure, three hypothetical patient profiles corresponding to three different degrees of severity on a waiting list were designed. Results Patients attributed greater importance to ART profiles (BWS score: patients 0.14 vs professionals -0.05; p<0.01) whereas professionals prioritized cataract surgery (patients 0.06 vs professionals 0.23; p<0.01). Concerning the profile severity, more severe profiles were prioritized in all procedures by both groups. Patients' and professionals' perspectives on the impact of the pandemic were similar, with exceptions: information received for resuming ART; health care provision in crisis situations; and reduction of parenting options. The pandemic affected patients' ability to conceive a child (70.4% of those surveyed), their psychological well-being (75.5%), and partner, social, and work relationships (69.4%). Conclusion Preference studies involving patients and professionals can provide important information to define framework criteria for the management of waiting lists for elective procedures, and to prioritize interventions during pandemic periods. The pandemic impact on infertility patients highlights the relevance of developing measures and strategies to cope with similar future situations in the most appropriate way.
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Affiliation(s)
- César Lizán Tudela
- Department of Paediatrics, Obstetrics and Gynaecology, Hospital Clínico Universitario, Valencia, 46010, Spain
| | - Irene Cuevas Sáiz
- Department of Paediatrics, Obstetrics and Gynaecology, Consorcio Hospital General Universitario de Valencia, Valencia, 46014, Spain
| | - Lorenzo Abad de Velasco
- Department of Paediatrics, Obstetrics and Gynaecology, Consorcio Hospital General Universitario de Valencia, Valencia, 46014, Spain
| | - Laura Gregori Navarro
- Department of Paediatrics, Obstetrics and Gynaecology, Hospital Clínico Universitario, Valencia, 46010, Spain
| | | | | | - Luis Lizán
- Outcomes 10 SLU, Castellón de la Plana, Spain
- Department of Medicine, Jaume I University, Castellón de la Plana, Spain
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Havrljenko J, Kopitovic V, Pjevic AT, Milatovic S, Pavlica T, Andric N, Pogrmic-Majkic K. The Prediction of IVF Outcomes with Autologous Oocytes and the Optimal MII Oocyte/Embryo Number for Live Birth at Advanced Maternal Age. Medicina (Kaunas) 2023; 59:1799. [PMID: 37893517 PMCID: PMC10608663 DOI: 10.3390/medicina59101799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Delayed childbearing in advanced age might be associated with a low prognosis for achieving pregnancy. Therefore, it is important to establish a predictive tool that will optimize the likelihood of a live birth at advanced age. Material and Methods: The retrospective study was conducted at the Ferona Fertility Clinic in Novi Sad (Republic of Serbia), between January 2020 and May 2021. The survey included 491 women aged ≥35 who met the inclusion criteria and who were subjected to an IVF (in vitro fertilization) treatment cycle. Results: The average number of retrieved oocytes, MII (metaphase II) oocytes, and developed embryos significantly decreased in advanced age. Age was also found to have a significant adverse effect on pregnancy and live birth rates. In women aged ≥35, 10/12 MII oocytes or 10/11 embryos are required for reaching an optimal live birth rate/cumulative live birth rate. Optimal CLBR (cumulative live birth rate) per one oocyte was achieved when 9 MII oocyte were retrieved. Conclusions: The study indicates that the cut-off for increased risk is ≥42 year. However, despite low live birth rates, autologous IVF for these women is not futile. An increase in the number of retrieved mature oocytes and a generation of surplus cryopreserved embryos could reinforce LBR (live birth rate) and CLBR. Clinicians should be very cautious in counseling, as autologous IVF may only be applicable to women with good ovarian reserve.
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Affiliation(s)
- Jelena Havrljenko
- Ferona Fertility Clinic, Sarplaninska 19, 21000 Novi Sad, Serbia or (J.H.); (V.K.); (A.T.P.)
- Faculty of Sciences, Department of Biology and Ecology, University of Novi Sad, Trg Dositeja Obradovica 2, 21000 Novi Sad, Serbia; (N.A.); (K.P.-M.)
| | - Vesna Kopitovic
- Ferona Fertility Clinic, Sarplaninska 19, 21000 Novi Sad, Serbia or (J.H.); (V.K.); (A.T.P.)
| | | | - Stevan Milatovic
- Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
| | - Tatjana Pavlica
- Faculty of Sciences, Department of Biology and Ecology, University of Novi Sad, Trg Dositeja Obradovica 2, 21000 Novi Sad, Serbia; (N.A.); (K.P.-M.)
| | - Nebojsa Andric
- Faculty of Sciences, Department of Biology and Ecology, University of Novi Sad, Trg Dositeja Obradovica 2, 21000 Novi Sad, Serbia; (N.A.); (K.P.-M.)
| | - Kristina Pogrmic-Majkic
- Faculty of Sciences, Department of Biology and Ecology, University of Novi Sad, Trg Dositeja Obradovica 2, 21000 Novi Sad, Serbia; (N.A.); (K.P.-M.)
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Stigliani S, Massarotti C, Maccarini E, Sozzi F, Rebora S, Scaruffi P, Anserini P. Telehealth for infertile patients during SARS-CoV-2 pandemic: far, and yet close. Minerva Obstet Gynecol 2023; 75:405-411. [PMID: 35333035 DOI: 10.23736/s2724-606x.22.05074-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In Italy during the first pandemic wave of SARS-CoV-2 the activity of fertility centers was stopped, with the exception of fertility preservation in oncological patients. We adopted telehealth and we evaluated whether it could help in the management of infertile couples at a fertility center. METHODS A longitudinal study performed at a public fertility center. Telehealth was offered to 72 couples referred to our center for a first consultation from March 17th to May 31st, 2020. Percentage of patients who performed the first assisted reproduction technology (ART) cycle or intrauterine insemination (IUI) within 6 months from the first visit and drop-out rate were analyzed during COVID-19 pandemic and compared to historical controls (couples admitted to our center in 2017-2019). RESULTS Eighty-five (61/72) percent of the couples accepted telehealth. Time to first treatment after online consultation in telehealth group (4.5±1.8 months) was significantly shorter (P=0.033) respect to time to first treatment after face-to-face visit of historical controls (7.5±6.9 months). After telehealth consultation, we observed a significant reduction (P=0.002) of drop-out rate from 39% in historical controls to 17% of telehealth group. Telehealth significantly diminished the drop-out rate also during the COVID-19 pandemic respect to 73% after traditional face-to-face visits (P=0.0005), with a time to first treatment of 3.7±2.1 months in couples who refused telehealth. CONCLUSIONS Telehealth could be a useful tool to facilitate the path of patients in a fertility center.
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Affiliation(s)
- Sara Stigliani
- Unit of Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Claudia Massarotti
- Unit of Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Elena Maccarini
- Unit of Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fausta Sozzi
- Unit of Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simona Rebora
- Unit of Clinical Psychology and Psychotherapy, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Paola Scaruffi
- Unit of Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy -
| | - Paola Anserini
- Unit of Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Digby AM, Dahan MH. Obstetrical and gynecologic implications of COVID-19: what have we learned over the first two years of the pandemic. Arch Gynecol Obstet 2023; 308:813-819. [PMID: 36633677 PMCID: PMC9838509 DOI: 10.1007/s00404-022-06847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/31/2022] [Indexed: 01/13/2023]
Abstract
The rapidly evolving nature of the coronavirus disease 2019 (COVID-19) pandemic has resulted in the publication of a breadth of information in the field of Obstetrics and Gynecology. This article is an examination of the impacts of COVID-19 on women's health, specifically on pregnancy, fertility, and delays to care. We review, in brief, the clinical presentation, transmission, and definitions of post-COVID conditions. Additionally, this article explores the reassuring evidence published regarding the use of mRNA vaccines in preconception and fertility treatments.
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Affiliation(s)
- Alyson M Digby
- Department of Gynecologic Reproductive Endocrinology and Infertility, McGill University, 888 Boul. de Maisonneuve E #200, Montreal, QC, H2L 4S8, Canada.
| | - Michael H Dahan
- Department of Gynecologic Reproductive Endocrinology and Infertility, McGill University, 888 Boul. de Maisonneuve E #200, Montreal, QC, H2L 4S8, Canada
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Asazawa K, Jitsuzaki M, Mori A, Ichikawa T, Kawanami M, Yoshida A. Implementation of a web-based partnership support program for improving the quality of life of male patients undergoing infertility treatment: a pilot feasibility study. BMC Res Notes 2023; 16:152. [PMID: 37480071 PMCID: PMC10362591 DOI: 10.1186/s13104-023-06431-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVES In this study, we aimed to implement and evaluate a Web-based partnership support program to enhance the QoL of male patients undergoing infertility treatment. We conducted a pilot study involving 41 infertile couples from September to October of 2021. We used a quasi-experimental design (pre-test and post-test with comparison) involving purposive sampling. A subgroup analysis was conducted to determine which demographics of the participants would benefit from the program. RESULTS Thirty-four participants (mean age 37.3 years; duration of infertility treatment 14.5 months) were included in the final analysis (follow-up rate 82.9%). Although there was no significant increase in the participants' QoL under the Web-based partnership support program, the assisted reproductive technology group (P = 0.03), the no medical history group (P = 0.032), and the with experience of changing hospital group (P = 0.027) showed a significant increase in the relational subscale scores of the QoL before and after the program. The majority of the participants (n = 29; 85.3%) expressed satisfaction with the support program. Participation in the Web-based partnership support program may improve the QoL of some men undergoing infertility treatment. Trial registration Retrospectively registered at the University Hospital Medical Information Network on 26 January 2023 (ID: UMIN0000 000050153).
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Affiliation(s)
- Kyoko Asazawa
- Division of Nursing, Tokyo Healthcare University, 2-5-1 Higashigaoka, Meguro, Tokyo, 152-8558, Japan.
| | - Mina Jitsuzaki
- Department of Nursing, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Akiko Mori
- Division of Nursing, Shonan Kamakura University of Medical Sciences, Kanagawa, Japan
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Ogawa K, Khan KN, Koshiba A, Fujishita A, Horiguchi G, Teramukai S, Itoh K, Guo SW, Mori T. Association between tissue stress reaction and ACE2/TMPRSS2 expression in endometria of reproductive aged women before and during Covid-19 pandemic. BMC Womens Health 2023; 23:229. [PMID: 37142998 PMCID: PMC10158702 DOI: 10.1186/s12905-023-02378-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND A potential concern has been raised regarding fertility and reproductive outcome during the Covid-19 pandemic with growing stress and anxiety. However, information on the association between tissue stress reaction and expression profiles of SARS-CoV-2 viral entry proteins, ACE2 and TMPRSS2, in endometria collected from women before (pre-pandemic) and during the Covid-19 pandemic (in-pandemic) is unknown. We aim to investigate the relationship between the expression of stress-reactive proteins and of ACE2 and TMPRSS2 in endometria collected from women during these two different time frames. METHODS We retrospectively retrieved tissue blocks of endometrial samples from 25 women in 2019 (pre-pandemic) and 25 women in 2020 (in-pandemic) who underwent hysterectomy for different gynecological indications. Immunohistochemical analysis was performed with endometrial tissue samples that were collected before and during the pandemic, using respective antibodies targeting ACE2/TMPRSS2, ADRB2 and NK1R (stress and anxiety receptor markers, respectively). The quantification of immunoreactive cells for each marker was calculated by the immunoreactive score (IRS) analysis. This retrospective cohort study was limited to small sample size. RESULTS No significant differences in the IRS of ACE2 and TMPRSS2 were found between the endometria that were collected before and during the pandemic with a lack of correlation between ACE2 and TMPRSS2 expression in respective endometria (r = 0.11, pre-pandemic; r = 0.04, in-pandemic). The immunostaining levels of stress marker, ADRB2 were significantly higher in the endometria of in-pandemic group (p = 0.015) comparing to that of pre-pandemic group. Pearson's correlation coefficient analysis showed a significant correlation in the expression between ADRB2 and TMPRSS2 (r = 0.41, p = 0.042) in the endometria of in-pandemic group but not in the pre-pandemic group. CONCLUSION The rise in stress and anxiety among women during current pandemic may elicit substantial amount of tissue stress reaction with consequent increase in the expression of SARS-CoV-2 viral entry proteins in their endometria. A lack of correlation between ACE2 and TMPRSS2 expression in endometria may reassure women in their reproductive age that they are not more susceptible to infection by SARS-CoV-2 and suggest that stressful women during this pandemic can safely decide to conceive naturally or by artificial reproductive technology.
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Affiliation(s)
- Kanae Ogawa
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, 602-8566, Kyoto, Japan
| | - Khaleque N Khan
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, 602-8566, Kyoto, Japan.
- The Clinical and Translational Research Center, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, 602-8566, Kyoto, Japan.
| | - Akemi Koshiba
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, 602-8566, Kyoto, Japan
| | - Akira Fujishita
- Department of Gynecology, Saiseikai Nagasaki Hospital, Nagasaki, Japan
| | - Go Horiguchi
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kyoko Itoh
- Department of Pathology and Applied Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sun-Wei Guo
- Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Taisuke Mori
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kamigyo-Ku, 602-8566, Kyoto, Japan
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Cirillo M, Basile V, Mazzoli L, Coccia ME, Fatini C. Impact of COVID-19 Pandemic on Women's Health and Obstetric Outcomes after Assisted Reproduction: A Survey from an Italian Fertility Center. J Pers Med 2023; 13:jpm13030563. [PMID: 36983744 PMCID: PMC10059757 DOI: 10.3390/jpm13030563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND the restrictive measures that were adopted during three waves of the COVID-19 pandemic had an impact on both the emotional state and lifestyle of the general population. We evaluated the impact of COVID-19 pandemic on lifestyles and emotional states of women planning assisted reproductive technology (ART), and whether these changes affected ART outcomes. METHODS quantitative research, using a web-based survey, was performed on 289 Caucasian women. RESULTS In preconception, we observed higher percentage of women with positive obstetric outcomes who reduced body weight (52.4% vs. 27.2%, p = 0.09). Over 60% of women with positive outcomes practiced physical activity vs. 47% of women with negative outcomes (p = 0.03), as well as having better quality of sleep (45% vs. 35%), and a more solid relationships with their partners (65.1% vs. 51.7%, p = 0.03). Women who increased their intake of whole grains, fruits, vegetables, and legumes (p < 0.05), according to the Mediterranean diet, showed positive outcomes. We observed that participants who experienced "very much" or "extreme" anxiety, sadness, and fear (p < 0.05) during pandemic were clearly more numerous in the group with negative pregnancy outcomes. CONCLUSIONS healthy lifestyle together with a positive emotional state in preconception can positively influence the obstetric outcomes after ART.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Valentina Basile
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Letizia Mazzoli
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
| | - Maria Elisabetta Coccia
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, 50134 Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
- Centre for Assisted Reproductive Technology, Division of Obstetrics and Gynaecology, Careggi University Hospital, 50134 Florence, Italy
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Vieira FDA, Neto RP, Morila MCG, Curimbaba JB, Pasquini DS, Felchner PCZ, Wandresen G, Pachnicki JPA. Fertility Does not Quarantine: Coronavirus Disease 2019 Pandemic Impacts on in Vitro Fertilization Clinical Pregnancy Rates. Rev Bras Ginecol Obstet 2023; 45:142-148. [PMID: 37105198 PMCID: PMC10166647 DOI: 10.1055/s-0043-1768459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE To understand the impact of the coronavirus disease 2019 pandemic on in vitro fertilization (IVF) clinical pregnancy rates and analyze factors that may have influenced their outcome. METHODS This was a retrospective observational study conducted at a tertiary-care Brazilian fertility center. All fresh IVF and embryo warming cycles performed from March 11 to December 31, 2018-2021 were analyzed, and their data were used to calculate fertilization, embryo cleavage, cycle cancellation, embryo transfer (ET), and clinical pregnancy rates. Statistical tests were used to evaluate the alterations found. Logistic regression models were used to explore the association of the categorical variables with the observed clinical pregnancy rates. Data from 2018 and 2019 (prepandemic) and 2020 and 2021 (pandemic) were grouped. RESULTS A total of 756 cycles were analyzed (n = 360 prepandemic and n = 396 pandemic). The age group of the patients, fertilization rates, and cleavage rates did not have significant differences (p > 0.05). There was a reduction in the percentage of fresh IVF and an increase in embryo warming cycles (p = 0.005) during the pandemic. There was also an increase in fresh cycle cancellations (p < 0.001) and a reduction in ET rates (p < 0.001). The pandemic had a negative impact on clinical pregnancy rates (p < 0.001) especially due to the increase in fresh cycle cancellations (p < 0.001). CONCLUSION Embryo warming cycles with subsequent frozen-thawed ET were presented as a viable alternative to continue assisted reproductive treatments against pandemic restrictions on fresh cycles, ensuring clinical pregnancy, albeit at a lower rate than that of the prepandemic period.
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Affiliation(s)
| | | | | | | | | | | | - Gustavo Wandresen
- Faculty of Medicine, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil
- Department of Human Reproduction, Embryo Human Reproduction Center, Curitiba, PR, Brazil
| | - Jan Pawel Andrade Pachnicki
- Faculty of Medicine, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil
- Faculty of Medicine, Positivo University, Curitiba, PR, Brazil
- Department of Tocogynecology, Faculty of Medicine, Federal University of Paraná, Curitiba, PR, Brazil
- Department of Gynecology, Faculty of Medicine, Mackenzie Evangelical College of Paraná, Curitiba, PR, Brazil
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11
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Marin L, Ambrosini G, Fantò FM, Della Vella M, Massaro A, Dessole F, Capobianco G, Andrisani A. Telemedicine for Virtual Consultations During COVID-19 Pandemic in a Medically Assisted Reproduction Center: Patients' Perspective. Telemed J E Health 2023; 29:459-465. [PMID: 35833792 DOI: 10.1089/tmj.2021.0509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Restrictive measures imposed to prevent COVID-19 contagion have caused an increase in waiting times for other health procedures. During the pandemic, utilization of telemedicine has increased to ensure patient care safely. The aim of this study was to evaluate the perspective of infertile patients who underwent virtual consultations for infertility. Materials and Methods: This was an observational study. A survey was submitted to patients who attended a virtual consultation at a single in vitro fertilization (IVF) unit between March 2020 and July 2021. The survey concerned their experience with telemedicine assessing the experience of video consulting and the software characteristics. Results: The survey response rate was 50.3% (n = 159). In total, 98.8% of patients positively rated the experience of telemedicine. Regarding the software itself, it was defined as intuitive and easy to use by 87.4% of patients. A majority (92.5%) of interviewed patients reported that they were able to receive the information and clear any doubts they had and 85.5% of interviewed patients would repeat the experience of video consultation. Conclusions: The acceptance of telemedicine was very high among infertile patients. However, IVF treatments have a strong emotional component and face-to-face consultation with medical staff might help to create the right climate of trust, and the empathy that can be demonstrated during a vis-à-vis meeting cannot be achieved through a screen. The use of telemedicine should be considered in those situations where it is not possible to attend an in-person consultation or when couples prefer it.
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Affiliation(s)
- Loris Marin
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Guido Ambrosini
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | | | - Manuela Della Vella
- Department of Women's and Children's Health, University of Padua, Padova, Italy
| | - Alberto Massaro
- Information Technology Department, Padua Hospital, Padova, Italy
| | - Francesco Dessole
- Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
| | - Giampiero Capobianco
- Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, Sassari, Italy
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12
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Lau BHP, Huang YT, Forth MW, Gietel-Basten S. Does Same-Sex Marriage Legalization Make Gay Men Want to Have Children? Findings from a Panel Study in Taiwan. Sex Res Social Policy 2023; 20:1-9. [PMID: 36817701 PMCID: PMC9913036 DOI: 10.1007/s13178-023-00801-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Introduction This study capitalized on prospective legal change in Taiwan to capture changes in gay men's desires and attitudes toward parenthood as a function of the legalization of same-sex marriage (SSM). Methods A panel of 731 gay men (mean age = 26.8 years ± 5.81) completed an online survey between 2019 and 2020, shortly before and 1½ years after the legalization of SSM, to report their parenting desire, marital status, and attitudes toward parenthood and marriage. Results This study found that fewer participants in the follow-up survey expressed a parenting desire (59.0% vs. 74.2%), and the perceived importance of parenthood dropped mildly (3.48 to 3.26, Cohen's d = 0.269). Those who expressed a consistent parenting desire attached greater importance to SSM. The perceived importance of SSM was modestly and positively related to the perceived importance of having a child. Conclusion Although the decrease in parenting desire and its perceived importance may be attributable to a lack of access to family-building options (e.g., surrogacy and adoption) and the COVID-19 pandemic, our findings illustrate that parenthood might become a next step for some Taiwanese male same-sex couples who married or considered marriage. Policy Implications The study findings provide information for policymakers to gauge the possible number of sexual minority men who might want to have a child and consider resource allocation and deliberation on policy changes related to reproduction.
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Affiliation(s)
- Bobo Hi-Po Lau
- Department of Counseling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Yu-Te Huang
- Department of Social Work and Social Administration, University of Hong Kong, Jockey Club Tower, Centennial Campus, HKU, Rm515, Hong Kong, China
| | - Marty W. Forth
- Department of Social Work and Social Administration, University of Hong Kong, Jockey Club Tower, Centennial Campus, HKU, Rm515, Hong Kong, China
| | - Stuart Gietel-Basten
- Division of Social Science, The Hong Kong University of Science and Technology, Hong Kong, China
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13
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Conte E, Di Girolamo R, D’Antonio F, Raffone A, Neola D, Saccone G, Dell’Aquila M, Sarno L, Miceli M, Carbone L, Maruotti GM. Do Anti-SARS-CoV-2 Monoclonal Antibodies Have an Impact on Pregnancy Outcome? A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11020344. [PMID: 36851222 PMCID: PMC9962092 DOI: 10.3390/vaccines11020344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Monoclonal antibodies (mAbs) have been used as a rescue strategy for pregnant women affected by COVID-19. To explore its impact on maternal-fetal health, we included all observational studies reporting maternal, fetal, delivery and neonatal outcomes in women who underwent mAbs infusion for COVID-19. Primary outcome was the percentage of preterm delivery. We used meta-analyses of proportions to combine data for maternal, fetal, delivery and neonatal outcome of women treated with mAbs for COVID-19 and reported pooled proportions and their 95% confidence intervals (CIs) for categorical variables or mean difference (MD) with their 95% confidence intervals for continuous variables. Preterm birth was observed in 22.8% of cases (95% CI 12.9-34.3). Fetal distress was reported in 4.2% (95% CI 1.6-8.2). Gestational hypertension and pre-eclampsia were observed in 3.0% (95% CI 0.8-6.8) and 3.4% (95% CI 0.8-7.5) of cases, respectively. Fetal growth restriction was observed in 3.2% of fetuses (95% CI 0.8-7.0). Secondary prophylaxis with mAbs is currently considered the best treatment option for people with mild to moderate COVID-19 disease. More attention should be paid to infants born from mothers who were treated with mAbs, for the risk of immunosuppression.
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Affiliation(s)
- Ennio Conte
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Raffaella Di Girolamo
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-746-2941
| | - Francesco D’Antonio
- Center for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, 66100 Chieti, Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant’Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy
| | - Daniele Neola
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Gabriele Saccone
- Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Michela Dell’Aquila
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Laura Sarno
- Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Marco Miceli
- Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy
| | - Luigi Carbone
- Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Maria Maruotti
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
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14
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Pappa K, Xydias EM, Ziogas AC, Bimba K, Tsakos E, Kolibianakis E. The Impact of Coronavirus Disease 2019 Pandemic on Female Patients Seeking or Undergoing Fertility Treatment in a Single In vitro Fertilisation Clinic in Greece: An International, Cross-sectional Study. J Hum Reprod Sci 2023; 16:50-56. [PMID: 37305776 PMCID: PMC10256943 DOI: 10.4103/jhrs.jhrs_11_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/13/2023] Open
Abstract
Background The temporary delay in fertility treatments due to the coronavirus disease 2019 (COVID-19) pandemic, in combination with the imposed lockdowns, has created psychological distress and anxiety amongst infertile patients. Aims The aim of this study was to evaluate how the pandemic has influenced assisted reproduction technology (ART) patients in Greece, during the second wave of the pandemic. An additional aim was to examine the effects of the pandemic on cross-border patients in particular, compared to national ones. Settings and Design This study was a cross-sectional, questionnaire-based study, distributed to 409 patients of a single in vitro fertilisation (IVF) clinic in Greece, during the period between January until the end of April 2021. Materials and Methods The survey was conducted online via E-mail and was distributed to national and international female patients of a single IVF clinic in Greece, who were undergoing ART treatment during the second wave of the COVID-19 pandemic. Patient participation was anonymous, and participants provided informed consent for collection and publication of data. Statistical Analysis Used The mean values of baseline characteristics, along with answer percentages per questionnaire item, were calculated. Collected data were cross-tabulated, and the Chi-square test was used as a measurement of the differences between national and cross-border patients. A P value lower than 0.05 was considered statistically significant. All analyses were conducted using the SPSS Statistics software. Results From 409 initial candidates, 106 women, with a mean age of 41.2 years, completed the questionnaire (26% response rate). The majority of national patients did not experience any delays in their fertility plans (62%), while cross-border patients experienced over 6 months of delays (54.7%). The main reason for fertility postponement was travel restrictions due to COVID-19 for cross-border patients (62.5%), while national patients cited additional reasons. The majority of patients experienced a degree of stress (65.2%) due to the delays, however were not fearful of COVID-19 infection (54.7%). Most patients were aware of the protective measures taken by IVF clinics (80.2%), and this was a determinant factor (71.7%) for their decision to restart their fertility treatment. Conclusion The COVID-19 pandemic lockdowns had a significant emotional impact on patient receiving or undergoing ART treatment in Greece. This impact was more pronounced on cross-border patients. This highlights the need for continuation of ART care, with the appropriate protective measures, during the pandemic, as well as during similar times of crisis in the future.
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Affiliation(s)
| | - Emmanouil M. Xydias
- Embryo Clinic IVF, Thessaloniki, Greece
- Department of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Apostolos C. Ziogas
- Department of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | | | | | - Efstratios Kolibianakis
- First Department of Obstetrics and Gynecology, Unit of Human Reproduction, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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15
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Lomova N, Dolgushina N, Tokareva A, Chagovets V, Starodubtseva N, Kulikov I, Sukhikh G, Frankevich V. Past COVID-19: The Impact on IVF Outcomes Based on Follicular Fluid Lipid Profile. Int J Mol Sci 2022; 24. [PMID: 36613453 DOI: 10.3390/ijms24010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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Horibe Y, Nakabayashi A, Murata S, Hashimoto T, Tabata T. COVID-19 infection control protocol and acceptance in an ART in vitro fertilization hospital. Middle East Fertil Soc J 2022; 27:19. [PMID: 35855738 PMCID: PMC9281231 DOI: 10.1186/s43043-022-00112-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose In Tokyo, where the highest coronavirus disease 2019 (COVID-19) infection rates have been reported nationally, we introduced and performed polymerase chain reaction (PCR) testing on the patients prior to them coming for oocyte retrieval (OR) or embryo transfer (ET) procedures. In addition, we recommended that patients self-inject ovarian stimulation drugs to reduce the number of hospital visits required. We aimed to assess the patient acceptance of these measures and the change of treatment number. Methods We conducted a retrospective study examining the patients coming for OR or ET, from the first time a state of emergency was declared in Japan, May 2020, until September 2021. Results A total of 79 out of 94 (94%) patients complied with the measures. This may reflect that PCR universal screening was accepted by most patients as necessary for reducing infection spread. In addition, the number of patients receiving OR and ET increased. The widespread adoption of work-from-home practices during the pandemic has made outpatient visits more acceptable to the general public. Conclusions Universal screening and self-injection are accepted and effective infection measures in patients presenting for OR and ET.
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17
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Scaravelli G, Levi Setti PE, Gennarelli G, Mencaglia L, Ubaldi FM, De Luca R, Cimadomo D, Spoletini R, Vigiliano V, Sileri PP. The actual impact of SARS-CoV-2/COVID-19 pandemic on IVF activity: a survey across Italian ART centers. J Assist Reprod Genet 2022; 39:2373-2380. [PMID: 35997867 PMCID: PMC9395871 DOI: 10.1007/s10815-022-02600-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/18/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose Since the end of February 2020, SARS-CoV-2 dramatically spread in Italy. To ensure that most of National Health System (NHS) resources were employed to control the pandemic, non-urgent medical procedures (including IVF) were suspended in March 2020. Here, we aimed at assessing the impact of the restrictive measures on Italian IVF activity. Methods In May 2020, the Italian ART Register launched an online survey (multiple choices and open answers) across ART centers (89.0% response rate; N = 170/191) to investigate how they were facing the emergency and estimate the reduction in their activity. In February 2022, the official data of the whole 2020 were published and retrospectively analyzed. The ART cycles conducted in Italy in 2020 (67,928 by 57,423 patients) were then compared to those conducted in 2019 (82,476 by 67,633 patients). The estimates formulated through the survey were compared to the actual reduction. Results In 2020, 14,548 less IVF cycles were conducted with respect to 2019 (− 17.6% reduction). This led to 2539 fewer live births (− 19.8%) than 2019. If the reduction unveiled by the survey launched in May 2020 (i.e., − 35%) would have persisted throughout 2020, a significantly larger impact was expected (4200 less newborns). Instead, the activity was gradually recovered, and it compensated the months of greatest emergency, thus fulfilling the most optimistic scenario. Conclusions Italy suffers from the lowest birth rate in Europe, and COVID-19 impact on IVF-derived live births testified how key ART is for Italian demographics. The government should support access to these treatments with dedicated actions. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-022-02600-2.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy
| | - Paolo Emanuele Levi Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Gianluca Gennarelli
- Obstetrics and Gynecology 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant'Anna Hospital, University of Torino, Turin, Italy.,Livet, GeneraLife IVF, Turin, Italy
| | - Luca Mencaglia
- Physiopathology of Reproduction, Santa Margherita Hospital, Cortona, Italy
| | | | - Roberto De Luca
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy.
| | | | - Roberta Spoletini
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy
| | - Vincenzo Vigiliano
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, National Health Institute, via Regina Elena, 299, 00161, Rome, Italy
| | - Pier Paolo Sileri
- Undersecretary for Health, Ministry of Health, Rome, Italy.,Vita-Salute San Raffaele University, Milan, Italy
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18
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Abstract
The SARS-CoV-2 virus continues to overwhelm health care systems impairing human to human social and economic interactions. Invasion or damage to the male reproductive system is one of the documented outcomes of viral infection. Existing studies have reported that SARS-CoV-2 may contribute to this loss in relation to inflammatory responses and the formation of cytokine storms in COVID-19 patients. Although direct infection of the testes and entry of SARS-CoV-2 into semen as well as subsequent consequences on the male reproductive system need to be studied more systematically, warnings from two organising ASRM and SART for prospective parents when infected with SARS-CoV-2 should be considered. In the context of an increasingly complex pandemic, this review provides preliminary examples of the potential impact of COVID-19 on male reproductive health and guidance for prospective parents currently infected with or recovering from SARS-CoV-2.
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Affiliation(s)
- T T Nguyen
- Faculty of Pharmacy, HUTECH University, Ho Chi Minh City, 700000, Vietnam
| | - J Hulme
- Department of BioNano Technology, Gachon University, Seongnam-si, 461-701, Republic of Korea.
| | - H D Tran
- Research Center for Genetics and Reproductive Health (CGRH), School of Medicine, Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, 700000, Vietnam
- Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, 700000, Vietnam
| | - T K Vo
- Ministry of Culture, Sports and Tourism, Vietnam Sports Hospital, Hanoi, 100000, Vietnam
- Department of Sports Medicine, University of Medicine and Pharmacy (VNU-UMP), Vietnam National University Hanoi, Hanoi, 100000, Vietnam
| | - G V Vo
- Research Center for Genetics and Reproductive Health (CGRH), School of Medicine, Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, 700000, Vietnam.
- Department of Biomedical Engineering, School of Medicine, Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, 700000, Vietnam.
- Vietnam National University-Ho Chi Minh City (VNU-HCM), Ho Chi Minh City, 700000, Vietnam.
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19
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Abigail A, Marisa B, Victoria L, Megha T, Lorna K, Kathleen B, Zain AS. Rates of COVID-19 infection among in vitro fertilization patients undergoing treatment at a university reproductive health center. J Assist Reprod Genet 2022; 39:2163-2168. [PMID: 35881271 PMCID: PMC9314538 DOI: 10.1007/s10815-022-02581-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) caused an unprecedented challenge for in-vitro fertilization (IVF) patients. The incidence of COVID-19 infection among this population is a fundamental knowledge gap. OBJECTIVE The purpose of this study was to determine the rate of COVID-19 infection among IVF patients compared to other gynecologic surgery patients. MATERIALS AND METHODS This retrospective study evaluated the incidence of COVID-19 infection among patients undergoing IVF, female fertility-related surgeries (FRS) and other gynecologic surgeries at a single academic institution in Los Angeles, California. All patients underwent routine COVID-19 polymerase chain reaction (PCR) screening prior to treatment. RESULT A total of 2742 patients underwent asymptomatic COVID-19 screening before a surgical procedure or IVF between March 1, 2020, and April 5, 2021. The rate of COVID-19 infection among patients who underwent preoperative testing for a non-fertility-related gynecologic procedure was 1.74% (28/1612). In comparison, the positive test results for those who underwent either FRS or IVF were 0.56% (1/180) and 0.34% (1/290), respectively, representing 6.70% (2/30) of positive tests for the whole cohort. The infertility patients had a significantly lower positivity rate compared to the other gynecologic patients during preoperative COVID-19 testing (0.43% vs 1.74%, p = 0.03). CONCLUSION(S) Our study demonstrated that there was a significantly lower incidence of COVID-19 infections in infertility patients undergoing IVF or FRS compared to other gynecologic surgery patients. Future studies should evaluate the cost-effectiveness of routine screening in both the gynecology and infertility patient population, especially in the setting of different variant surges and vaccination rates.
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Affiliation(s)
- Armstrong Abigail
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA
| | - Berger Marisa
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA.
| | - Lee Victoria
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Tandel Megha
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Kwan Lorna
- Department of Urology, University of California Los Angeles, Los Angeles, CA, USA
| | - Brennan Kathleen
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA
| | - Al-Safi Zain
- Department of Obstetrics & Gynecology, University of California Los Angeles, Los Angeles, CA, USA
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20
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Carbone L, Trinchillo MG, Di Girolamo R, Raffone A, Saccone G, Iorio GG, Gabrielli O, Maruotti GM. COVID
‐19 vaccine and pregnancy outcomes: a systematic review and meta‐analysis. Int J Gynaecol Obstet 2022; 159:651-661. [PMID: 35810414 PMCID: PMC9349529 DOI: 10.1002/ijgo.14336] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Luigi Carbone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
| | - Maria Giuseppina Trinchillo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
| | - Raffaella Di Girolamo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero‐Universitaria di Bologna. S. Orsola Hospital, University of Bologna Bologna Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
| | - Giuseppe Gabriele Iorio
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
| | - Olimpia Gabrielli
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
| | - Giuseppe Maria Maruotti
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II Naples Italy
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21
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Abstract
AIM This study evaluated the level of fear and anxiety related to the COVID-19 outbreak, in infertile women whose ART cycles were delayed due to the pandemic. MATERIALS AND METHODS An online survey was sent to women whose ART cycles were postponed due to the COVID-19 outbreak between April and May 2020. The study population were 101 participants. The main outcome measure is to determine the levels of fear and anxiety in infertile women by using the Spielberger State-Trait Anxiety Inventory (STAI-T and STAI-S) and Fear of COVID-19 scale (FCV-19S). The relationship of the COVID-19 outbreak with the willingness to go ahead with the desire for pregnancy was also assessed. RESULTS The state-anxiety levels were significantly higher in women above 35 years (45.0 ± 5.2 vs. 42.2 ± 4.5, p = 0.006). Women with diminished ovarian reserve had a higher state-anxiety compared to other causes, but were not found to be significant (44.7 ± 5.2 vs. 42.5 ± 5.0, p = 0.173). Women who thought that the possibility of not being able to get pregnant was more important than being infected with the COVID-19 had higher anxiety levels than women who thought just the opposite. The diminished ovarian reserve and high duration of infertility were found to be significantly associated with higher anxiety levels (OR = 2.5, p < 0.05). The diminished ovarian reserve and previous ART failure significantly predicted the presence of clinical state-anxiety. CONCLUSION The state-anxiety was found to be higher in women whose cycles were postponed due to the outbreak and the presence of diminished ovarian reserve also significantly affected anxiety levels. Further research is needed to assess whether COVID-19 will have any impact on ART treatments in the next few years.
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Affiliation(s)
- Vehbi Yavuz Tokgoz
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
| | - Yeliz Kaya
- Department Obstetric And Women's Disease Nursing, Eskisehir Osmangazi University, Faculty of Health Sciences, Eskisehir, Turkey
| | - Ahmet Basar Tekin
- Department of Obstetrics and Gynecology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey
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22
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Romeiro J, Nogueira P, Caldeira S. Validation of the Portuguese Version of the Fertility Adjustment Scale. Healthcare (Basel) 2022; 10:563. [PMID: 35327041 PMCID: PMC8954057 DOI: 10.3390/healthcare10030563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 02/04/2023] Open
Abstract
There is an urgent need to provide healthcare professionals and midwives with validated tools as to improve fertility adjustment and promote well-being of couples with infertility. The purpose of this study was to test validity of the Fertility Adjustment Scale among people undergoing assisted reproductive techniques. A cross-sectional and methodological study was conducted, and a total of 104 Portuguese adults undergoing fertility treatment were recruited through fertility-related websites. The Fertility Adjustment Scale was administered along with the Spiritual Well-Being Questionnaire and the Resilience Scale for adults as a measure of concurrent validity. Scores revealed the sample’s lack of adjustment to fertility. A significant correlation with measures of resilience provided evidence of convergent validity. There was a significant association of fertility adjustment with time of consultation and the cause of infertility. A Fertility Adjustment Scale with six items is a reliable tool that offers early recognition of patients’ difficulties in adaptation to fertility problems during assisted reproductive techniques, which could be beneficial in not only an early recognition of healthcare intervention but of a more individualized approach to such patients.
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23
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Castiglione Morelli MA, Iuliano A, Schettini SCA, Ferri A, Colucci P, Viggiani L, Matera I, Ostuni A. Are the Follicular Fluid Characteristics of Recovered Coronavirus Disease 2019 Patients Different From Those of Vaccinated Women Approaching in vitro Fertilization? Front Physiol 2022; 13:840109. [PMID: 35283772 PMCID: PMC8905595 DOI: 10.3389/fphys.2022.840109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/26/2022] [Indexed: 12/18/2022] Open
Abstract
The aim of this pilot study is to evaluate if SARS-CoV-2 infection or vaccination against SARS-CoV-2 infection induce observable metabolic effects in follicular fluid of women who are following in vitro fertilization (IVF) treatments. The possible impact of coronavirus disease 2019 (COVID-19) on fertility and IVF outcome is considered. We have selected for this study: six women vaccinated against SARS-CoV-2 infection, five recovered COVID-19 patients, and we used nine healthy women as the control group. At the time of oocytes retrieval from participants in the study, follicular fluids were collected and metabolomic analysis was performed by 1H NMR spectroscopy in combination with multivariate analysis to interpret the spectral data. The search for antibody positivity in the follicular fluid aspirates was also carried out, together with the western blotting analysis of some inflammatory proteins, interleukin-6, tumor necrosis factor α (TNFα), and the free radical scavenger superoxide dismutase 2. Higher levels of Ala and Pro together with lower levels of lipids and trimethylamine N-oxide (TMAO) were found in follicular fluids (FFs) of vaccinated women while lower levels of many metabolites were detected in FFs of recovered COVID patients. Expression level of TNF-α was significantly lower both in recovered COVID-19 patients and vaccinated women in comparison to healthy controls.
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Affiliation(s)
| | - Assunta Iuliano
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | | | - Angela Ferri
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Paola Colucci
- Center for Reproductive Medicine of "San Carlo" Hospital, Potenza, Italy
| | - Licia Viggiani
- Department of Sciences, University of Basilicata, Potenza, Italy
| | - Ilenia Matera
- Department of Sciences, University of Basilicata, Potenza, Italy
| | - Angela Ostuni
- Department of Sciences, University of Basilicata, Potenza, Italy
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24
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Varlas VN, Borș RG, Pop AL, Năsui BA, Bacalbasa N, Bohîlțea R, Vlădăreanu R, Manolea C. Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields. J Clin Med 2022; 11:jcm11051221. [PMID: 35268312 PMCID: PMC8911324 DOI: 10.3390/jcm11051221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.
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Affiliation(s)
- Valentin Nicolae Varlas
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Roxana Georgiana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Anca Lucia Pop
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Clinical Laboratory, Food Safety, Carol Davila University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania
| | - Bogdana Adriana Năsui
- Department of Community Health, Iuliu Hațieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Nicolae Bacalbasa
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Cantacuzino Clinical Hospital, 030167 Bucharest, Romania
| | - Roxana Bohîlțea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Radu Vlădăreanu
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynecology, Elias Clinical Hospital, 17 Mărăști Blvd., 011461 Bucharest, Romania
| | - Corina Manolea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Assisted Reproduction Department, Columna Medical Center, 021522 Bucharest, Romania
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25
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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26
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Kostova D, Stoev S, Tachkov K, Petrova G. Cost-effectiveness of in vitro fertilization and controlled ovarian hyperstimulation before and after the COVID-19 outbreak. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2021.2022993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Diana Kostova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
- Hospital Pharmacy Department, Obstetrics and Gynecology Hospital for Active Treatment "Doctor Shterev", Sofia, Bulgaria
| | - Svetoslav Stoev
- Hospital Pharmacy Department, Obstetrics and Gynecology Hospital for Active Treatment "Doctor Shterev", Sofia, Bulgaria
- Department of Pharmaceutical sciences and Social Pharmacy, Faculty of Pharmacy, Medical University of Pleven, Pleven, Bulgaria
| | - Konstantin Tachkov
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Department of Organisation and Economy of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
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27
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Wu Y, Zhang X, Wang Z, Xia X. Can We Cryopreserve the Sperm of COVID-19 Patients During the Pandemic? Front Endocrinol (Lausanne) 2022; 13:753267. [PMID: 35712235 PMCID: PMC9197193 DOI: 10.3389/fendo.2022.753267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
An extreme strain has been placed on healthcare facilities in the COVID-19 era. Initial stage of the pandemic, national and international societies for reproductive medicine suggested the suspension of new IVF treatments and non-essential cryopreservation of gametes. Accordingly, the demands of cryopreservation of semen with COVID-19 patients also was suspended by some of cryobanks to protect staff and patients from unnecessary viral exposure at the acute stage. However, the pandemic may stay with us longer than expected. In addition, there will be some male COVID-19 patients with cancer or critically illness who needs to cryopreserve their semen before medical treatments, otherwise they might loss the chance of getting their own offspring. In this document, we summarize available evidence to deepen and expand awareness of feasibility of sperm cryopreservation and propose some suggestions to help cryobanks carry out sperm preservation procedure for COVID-19 male patients.
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Affiliation(s)
- Yongming Wu
- Human sperm bank, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoxue Zhang
- COVID‐19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Science, Nanjing Normal University, Nanjing, China
| | - Zhiqiang Wang
- Human sperm bank, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinyi Xia
- COVID‐19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China
- *Correspondence: Xinyi Xia,
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28
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Săndulescu MS, Văduva CC, Siminel MA, Dijmărescu AL, Vrabie SC, Camen IV, Tache DE, Neamţu SD, Nagy RD, Carp-Velişcu A, Manolea MM. Impact of COVID-19 on fertility and assisted reproductive technology (ART): a systematic review. Rom J Morphol Embryol 2022; 63:503-510. [PMID: 36588488 PMCID: PMC9926143 DOI: 10.47162/rjme.63.3.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The appearance of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a major obstacle for the performing of current medical activities throughout the world. COVID-19 has affected humanity in many ways, thus causing a great medical, social, economic, and political instability. The aim of this study was to make an analysis of the scientific data obtained by so far to highlight the impact that COVID-19 has had on fertility and assisted reproductive technology (ART). Infection with SARS-CoV-2 alters the normal immune response by local and systemic damage to tissues and organs. After the virus enters the body, the first lesions are produced in the respiratory tract. Extrapulmonary lesions specific to COVID-19 include acute renal lesions/acute kidney damage, hepatocellular lesions, neurological diseases, myocardial dysfunction and arrhythmia, gastrointestinal diseases but also genital impairment. The possible impairment of the male reproductive system is because angiotensin-converting enzyme 2 (ACE2) receptors are in an increased number in the testes, seminiferous duct cells, spermatogonia, Leydig cells and Sertoli cells. Many published studies to date have pointed out that COVID-19 could also affect female fertility and disrupt the functions of the female reproductive system. The theory that this virus can also be transmitted sexually and can cause infertility or testicular damage is supported by the fact that the virus can be isolated in the semen of COVID-19 patients but only during the disease. Choosing the best method of treating infertility during the COVID-19 pandemic is multifactorial, but the risk of infection and compliance with specific ART hygiene protocols must always be considered. Currently, there is no scientific basis regarding the fact that the COVID-19 vaccination would influence fertility.
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Affiliation(s)
- Maria Sidonia Săndulescu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;
| | - Constantin-Cristian Văduva
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Mirela Anişoara Siminel
- Department of Neonatology, University of Medicine and Pharmacy of Craiova, Romania , Department of Neonatology, Filantropia Municipal Hospital, Craiova, Romania
| | - Anda Lorena Dijmărescu
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Sidonia Cătălina Vrabie
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
| | - Ioana Victoria Camen
- Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania , PhD Student, Doctoral School, University of Medicine and Pharmacy of Craiova, Romania
| | - Daniela Elise Tache
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Romania
| | - Simona Daniela Neamţu
- Department of Hematology and Immunology, University of Medicine and Pharmacy of Craiova, Romania
| | - Rodica Daniela Nagy
- Department of Obstetrics and Gynecology, Emergency County Hospital, Craiova, Romania
| | - Andreea Carp-Velişcu
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania , Department of In Vitro Fertilization, Prof. Dr. Panait Sîrbu Clinical Hospital of Obstetrics and Gynecology, Bucharest, Romania
| | - Maria Magdalena Manolea
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania , Department of Obstetrics and Gynecology, Filantropia Municipal Hospital, Craiova, Romania
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29
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Carbone L, Di Girolamo R, Mappa I, Saccone G, Raffone A, Di Mascio D, De Vivo V, D'Antonio F, Guida M, Rizzo G, Maria Maruotti G. Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review. Eur J Obstet Gynecol Reprod Biol 2022; 268:144-164. [PMID: 34920272 PMCID: PMC8648617 DOI: 10.1016/j.ejogrb.2021.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND SARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy. OBJECTIVE To evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women. STUDY DESIGN We performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated. RESULTS 15 studies including 25,839 women were included in the analysis. The proportion of women actually willing to be vaccinated during pregnancy is 49.1% (95% CI, 42.3-56.0), and the proportion of breastfeeding women is 61.6% (95% CI, 50.0-75.0). CONCLUSION The cumulative SARS-CoV-2 vaccine acceptance rate among pregnant women appears still low. Vaccinal campaign are urgently needed to drive more confidence into the vaccine to help reducing the spread of the infection and the possible consequences during pregnancy.
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Affiliation(s)
- Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Raffaella Di Girolamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy; Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.
| | - Ilenia Mappa
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentino De Vivo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Francesco D'Antonio
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Giuseppe Rizzo
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy; Department of Obstetrics and Gynecology, The First I. M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
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30
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Carbone L, Di Girolamo R, Mappa I, Saccone G, Raffone A, Di Mascio D, De Vivo V, D'Antonio F, Guida M, Rizzo G, Maria Maruotti G. Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review. Eur J Obstet Gynecol Reprod Biol 2021. [PMID: 34920272 DOI: 10.1016/j.ejogrb.2021.12.003.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND SARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy. OBJECTIVE To evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women. STUDY DESIGN We performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated. RESULTS 15 studies including 25,839 women were included in the analysis. The proportion of women actually willing to be vaccinated during pregnancy is 49.1% (95% CI, 42.3-56.0), and the proportion of breastfeeding women is 61.6% (95% CI, 50.0-75.0). CONCLUSION The cumulative SARS-CoV-2 vaccine acceptance rate among pregnant women appears still low. Vaccinal campaign are urgently needed to drive more confidence into the vaccine to help reducing the spread of the infection and the possible consequences during pregnancy.
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Affiliation(s)
- Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Raffaella Di Girolamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy; Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy.
| | - Ilenia Mappa
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Antonio Raffone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Valentino De Vivo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Francesco D'Antonio
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
| | - Giuseppe Rizzo
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy; Department of Obstetrics and Gynecology, The First I. M. Sechenov Moscow State Medical University, Moscow, Russia
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, Federico II University of Naples, Naples, Italy
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Cutting E, Catt S, Vollenhoven B, Mol BW, Horta F. The impact of COVID-19 mitigation measures on fertility patients and clinics around the world. Reprod Biomed Online 2021; 44:755-763. [PMID: 35190253 PMCID: PMC8712431 DOI: 10.1016/j.rbmo.2021.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/02/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Elizabeth Cutting
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia.
| | - Sally Catt
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia
| | - Beverley Vollenhoven
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Womens and Newborn Program Monash Health, Clayton, Melbourne Victoria, Australia; Monash IVF, Clayton, Melbourne Victoria, Australia
| | - Ben W Mol
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Womens and Newborn Program Monash Health, Clayton, Melbourne Victoria, Australia
| | - Fabrizzio Horta
- Education Program in Reproduction and Development (EPRD), Department of Obstetrics and Gynaecology, Monash University, Clayton, Melbourne Victoria, Australia; Monash IVF, Clayton, Melbourne Victoria, Australia
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Crispi CP Jr, Crispi CP, de Almeida Nogueira E, Balthar PC, Guerra CGS, de Freitas Fonseca M. Endometriosis Surgery during the First Wave of the COVID-19 Pandemic: A Brazilian Single Institution Experience. Case Rep Obstet Gynecol 2021; 2021:5040873. [PMID: 34721912 DOI: 10.1155/2021/5040873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction. Early in the 2020 Coronavirus pandemic stay-at-home guidelines, there were public health orders that elective surgeries be deferred to prioritize hospital beds for critically ill COVID-19 patients. Besides, several reasons led to the postponement of consultations, diagnostic tests, and elective therapeutic procedures. As a result, some women with endometriosis faced chronification of their pain and decreased prospects for pregnancy. The aim of this study was to describe individual responses to minimally invasive complete excision of endometriosis through 40 days of follow-up of women whose endometriosis was considered severe enough to proceed with surgery during the fourth, fifth, and sixth months of constraints imposed by the pandemic. Preventive strategies and safety measures employed to protect patients and staff from acquiring or transmitting Coronavirus infection are presented. Case Presentation. This case series report enrolled 11 consecutive Brazilian women (ages 22 to 47 y) who underwent minimally invasive surgical treatment of endometriosis between June 26 and August 17, 2020. Cases of endometriosis requiring more urgent surgery were promptly identified and considered individually. The strict safety measures were well accepted by patients. No women developed any flu-like or COVID-19-related symptoms (cough, dyspnea, fever, or anosmia) in the 40 days of postoperative follow-up. One of the most praised measures reported by patients was the routine testing of the patient, the person who would accompany her in the hospital, and all medical staff and employees. Discussion. It is feasible to safely perform elective endometriosis surgery in selected cases during a pandemic.
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Siregar MFG, Siregar EKH. The Effect of Coronavirus Disease 2019 on Reproduction System and Fertility. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
As of October 9, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was recorded to have infected more than 235 countries and 36,361,054 people globally, and 1,056,186 people died from coronavirus disease 2019 (COVID-19). In early October 2020, it was reported that the rate of increase in new cases reached 300,000 cases per day. A scientific reference source about COVID-19 in pregnancy and fertility system based on the results of previous research. By conducting a literature search that was carried out until October 12, 2020, through the PubMed and Google Scholar databases using the keyword COVID-19 and pregnancy, 20 articles were used as a reference source. Human SARS-CoV appeared in China, causing a deadly epidemic 18 years ago. Novel coronavirus-2019 infects target cells by binding to angiotensin-converting enzyme 2 (ACE2) through its surface spike protein. nCoV-2 modulates ACE2 expression and causes serious injury, similar to SARS-CoV. There is the possibility that the SARS-CoV-2 mechanism can affect fertility on female, namely, SARS-CoV-2 can harm ovarian tissue and granulosa cells, and reduce ovarian function and quality of oocytes, and can make infertility or miscarriage; also damage the endometrial epithelium and affect early embryo implantation. COVID-19 is caused by SARS-CoV-2 which is an acute infectious disease that mostly affects the respiratory system, but can also attack the reproductive system.
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Nobre Meirinhos J, Vattaire M, Barry F, Denjean L, Bouricha M, Gala A, Ferrières-Hoa A, Loup V, Gaspari L, Brouillet S, Hamamah S. [Impact of SARS-CoV-2 on fertility, gametes' quality and Assisted Reproduction Technology]. ACTA ACUST UNITED AC 2021; 50:173-181. [PMID: 34506995 PMCID: PMC8423662 DOI: 10.1016/j.gofs.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Indexed: 11/27/2022]
Abstract
Le contexte actuel de pandémie conduit à s’interroger sur les conséquences de la COVID-19 en Assistance médicale à la procréation (AMP). En effet, suite aux premières recommandations de l’Agence de la biomédecine en mars 2020, les centres d’AMP ont suspendu leurs activités. La reprise progressive des tentatives en mai 2020 s’est accompagnée de nombreux questionnements, concernant les effets directs et indirects du SARS-CoV-2 sur la qualité des gamètes, la gamétogenèse, la fertilité, la grossesse et la santé néonatale. L’objectif de cette revue de la littérature est de synthétiser les données disponibles, pour informer les patient(e)s pris(es) en charge et adapter les pratiques d’AMP en cette période de la COVID-19. La plupart des études récentes se basent sur l’évaluation des effets du syndrome infectieux, sur l’analyse des facteurs hormonaux, et sur l’expression des protéines d’entrée virale (ACE2 et TMPRSS2) au niveau des cellules impliquées dans la gamétogenèse pour évaluer les répercussions de la COVID-19. La transmission materno-fœtale du SARS-CoV-2 n’a pas pu être démontrée à ce jour, mais l’infection néonatale reste possible. Néanmoins, les hommes seraient plus à risque d’être infectés par le SARS-CoV-2, d’être symptomatiques et la spermatogenèse est vraisemblablement affectée. La présence du virus dans le sperme est un évènement rare, mais l’ensemble de ces paramètres sont à prendre en compte dans la prise en charge des couples en AMP. Cependant, aucune conséquence sur la qualité des gamètes féminins n’a été mise en évidence jusqu’à présent.
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Affiliation(s)
- Julie Nobre Meirinhos
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Margot Vattaire
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Fatima Barry
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Louise Denjean
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Molka Bouricha
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Anna Gala
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Alice Ferrières-Hoa
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Vanessa Loup
- Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Laura Gaspari
- Inserm 1203, développement embryonnaire précoce humain et pluripotence, Embryopluripotency, université de Montpellier, Montpellier, France; Service de pédiatrie, unité d'endocrinologie-gynécologie pédiatrique, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Sophie Brouillet
- Inserm 1203, développement embryonnaire précoce humain et pluripotence, Embryopluripotency, université de Montpellier, Montpellier, France; Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France
| | - Samir Hamamah
- Inserm 1203, développement embryonnaire précoce humain et pluripotence, Embryopluripotency, université de Montpellier, Montpellier, France; Département de biologie de la reproduction, biologie de la reproduction/DPI et CECOS, CHU d'Arnaud de Villeneuve Montpellier, université de Montpellier, Montpellier, France.
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Allahbadia G. Will Procreation Ever Be The Same After COVID-19? J Obstet Gynaecol India 2021;:1-6. [PMID: 34483511 DOI: 10.1007/s13224-021-01536-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022] Open
Abstract
Medically assisted procreation will never be the same again after this China Virus epidemic. With billions of lives being affected by this damaging global pandemic, medically assisted procreation services were not left unharmed with far-reaching consequences. New challenges are now emerging concerning COVID-19, such as associated reproductive implications and the consequences of assisted and natural procreation in the presence of acute SARS-CoV-2 infection and delayed consequences after patient recovery. There is a hypothesis that testicular damage and subsequent infertility may result following COVID-19 infection and the possibility of sexual transmission, as SARS-CoV-2 has been identified in the semen of infected patients. Vaccine hesitancy in young women planning pregnancies has been heightened because of the spread of misinformation on social media stating that COVID-19 vaccines will cause sterility in women. Reassuring data from accidental pregnancies that have occurred in the clinical trials of approved COVID-19 vaccines indicate that vaccination does not harm fertility or increase the rate of miscarriage. Scientists have quickly related to good tissue practices in vitro fertilization and a rethink is on about encouraging biopsies and focusing on safe vitrification protocols keeping in mind that ova, sperm, and embryos could be possible vectors for disease transmission with the limited research on the SARS-CoV-2 virus. Going ahead with segmented IVF without delay, freezing the generated embryos and pushing back the embryo transfer after the pandemic appears to be the best strategy at present. An international group of researchers have proposed a prognostic stratification of more vulnerable infertility cases in order to plan a progressive restart of worldwide fertility treatments.
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Hezavehei M, Shokoohian B, Nasr-Esfahani MH, Shpichka A, Timashev P, Shahverdi AH, Vosough M. Possible Male Reproduction Complications after Coronavirus Pandemic. Cell J 2021; 23:382-388. [PMID: 34455712 PMCID: PMC8405085 DOI: 10.22074/cellj.2021.7982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/29/2021] [Indexed: 12/23/2022]
Abstract
Coronavirus disease 2019 (COVID-19), as a severe respiratory disease, affects various tissues and organs. The
specific SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2), is highly expressed in male gonads. Thus,
male reproductive tissues could be a potential target for virus colonization. We performed a comprehensive search in
PubMed and Google Scholar to retrieve relevant articles published till 15 April 2021. The keywords used were: male
fertility, male reproductive health, semen parameters, sex hormones, SARS-CoV-2, and COVID-19. Validated evidence
about the adverse effects of the SARS-CoV-2 infection on the male reproductive system is limited and few studies have
reported semen analysis results or presence of viral RNA in semen samples of infected men. Nevertheless, alterations
in reproductive hormones such as decreased level of testosterone (T) with raised luteinizing hormone (LH) have been
reported in some patients. Although the impact of SARS-CoV-2 infection on the male reproduction health remains
unclear, evidence suggests that male gonads may be potentially vulnerable to SARS-CoV-2 infection. In this article,
we discussed the possible impacts of COVID-19 on male gonads, sex hormones, and semen quality and suggested
preventive solutions.
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Affiliation(s)
- Maryam Hezavehei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Bahare Shokoohian
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | | | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russian
| | - Abdol Hossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Carbone L, Raffone A, Travaglino A, Sarno L, Conforti A, Gabrielli O, De Vivo V, De Rosa M, Migliorini S, Saccone G, Locci M, Alviggi C, Mollo A, Guida M, Zullo F, Maruotti GM. Obstetric A&E unit admission and hospitalization for obstetrical management during COVID-19 pandemic in a third-level hospital of southern Italy. Arch Gynecol Obstet 2021; 305:859-867. [PMID: 34455467 PMCID: PMC8403252 DOI: 10.1007/s00404-021-06212-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 08/24/2021] [Indexed: 12/25/2022]
Abstract
Background The COronaVIrus Disease 2019 (COVID-19) has spread in Italy since February 2020, inducing the government to call for lockdown of any activity, apart primary needs, during the months March–May 2020. During the lockdown, a reduction of admissions and hospitalizations for ischemic diseases was noticed. Purpose of this study was to observe if there has been the same reduction trend in Accident & Emergency (A&E) unit admissions also for obstetric-gynecological conditions. Methods Medical records and electronic clinical databases were searched for all patients who were admitted to the obstetric A&E department or hospitalized at the Gynecology and Obstetrics Unit of University hospital of Naples Federico II, during the quarter March–May in the years 2019 and 2020. The mean ± standard deviation (SD) of monthly admission to the obstetric A&E department and hospitalization of the year 2020 was compared with that of the year 2019, using the unpaired T test with α error set to 0.05 and 95% confidence intervals (95% CI). Results Admissions were 1483 in the year 2020 and 1786 in 2019. Of total, 1225 (37.5%) women were hospitalized: 583 in the year 2020, 642 in 2019. Mean ± SD of patients monthly admitted to our obstetric A&E department was 494 ± 33.7 in the year 2020, and 595.3 ± 30.9 in 2019, with a mean difference of − 101.3 (95% CI − 103.5 to − 99.1; p < 0.0001). Mean ± SD of patients monthly hospitalized to our department was 194 ± 19.1 in the year 2020, 213.7 ± 4.7 in 2019, with a mean difference of − 19.7 (95% CI − 23.8 to − 15.6; p < 0.0001). Conclusion A significant decrease in the mean of monthly admissions and hospitalizations during the COVID-19 pandemic when compared to the previous year was found also for obstetric–gynecological conditions. Further studies are necessary to assess COVID-19 impact and to take the most appropriate countermeasures.
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Affiliation(s)
- Luigi Carbone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Antonio Raffone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Laura Sarno
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Alessandro Conforti
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Olimpia Gabrielli
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Valentino De Vivo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Martina De Rosa
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Sonia Migliorini
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Gabriele Saccone
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Mariavittoria Locci
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Carlo Alviggi
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Antonio Mollo
- Department of Medicine, Surgery and Dentistry, Schola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy
| | - Maurizio Guida
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Fulvio Zullo
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Giuseppe Maria Maruotti
- Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
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Li L, Cao Y, Fan J, Li T, Lang J, Zhang H, Lv J, Zhu L. Impact of COVID-19 Pandemic on the Clinical Activities in Obstetrics and Gynecology: A National Survey in China. Front Med (Lausanne) 2021; 8:633477. [PMID: 34395457 PMCID: PMC8360866 DOI: 10.3389/fmed.2021.633477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 07/06/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: Few studies have quantified the influence of coronavirus disease 2019 (COVID-19) pandemic on medical providers. This is the first national study to investigate the impact of the pandemic on physicians practicing obstetrics and gynecology in China. Methods: A two-stage, stratified, cluster sampling method was performed based on the city categories (category 1, fewer than 10,000 beds; category 2, 10,000–30,000; and category 3, more than 30,000) and public hospital levels (primary, secondary, and tertiary). Physicians practicing obstetrics and gynecology reported the relevant changes in their general clinical activities and changes in the management of specific diseases or conditions occurring during the periods that they were most strongly affected. These changes were compared by municipal and hospital characteristics. Results: Questionnaires were collected from a representative sample of 11,806 physicians actively practicing obstetrics and gynecology in 779 hospitals from 157 cities of 31 provinces. Except emergency visits and online consultations, category 3 cities, tertiary hospitals and general hospitals had greater reductions in overall clinical activities than category 1 cities, primary hospitals and specialized hospitals (all adjusted p < 0.05), respectively. The differences also existed in the management of specific diseases and conditions, especially for less urgent conditions, including cervical cancer screening, instructions regarding contraception and miscarriage, and assisted reproduction (all p < 0.05). Conclusions: During the COVID-19 pandemic, the clinical obstetrics and gynecology activities in China markedly decreased, with significant differences across municipal and hospital characteristics. Trial Registration: This study was registered with ClinicalTrials.gov on July 27, 2020 (NCT04491201).
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Affiliation(s)
- Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Yang Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Junning Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ting Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, United States
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
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Manolea C, Capitanescu A, Borș R, Rugescu I, Bechir M, Mehedintu C, Varlas V. The prevalence of SARS-CoV-2 antibodies in triage-negative patients and staff of a fertility setting from lockdown release throughout 2020. Hum Reprod Open 2021; 2021:hoab028. [PMID: 34322605 PMCID: PMC8313405 DOI: 10.1093/hropen/hoab028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/10/2021] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION What is the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in triage-negative patients undergoing ART and fertility care providers after lockdown release and throughout 2020? SUMMARY ANSWER Out of the triage-negative patients whose blood samples were assessed for SARS-CoV-2 antibodies over 6 months, 5.2% yielded positive results with a significantly higher rate in health care workers (HCWs) and a significant month-by-month increase in those with evidence of antibodies. WHAT IS KNOWN ALREADY Patients of reproductive age are more prone to asymptomatic or minimal forms of coronavirus disease 2019 (COVID-19) as compared to older age groups, and the identification of those with active infection and those already exposed (and probably immunized) is important for safety and cost-effective use of testing resources in the fertility setting. Data on the prevalence of SARS-CoV-2 in ART patients are limited and encompass short time frames; current rates are unknown. There is also no consensus on the optimal way of screening triage-negative ART patients in moderate/high-risk areas. STUDY DESIGN, SIZE, DURATION A prospective longitudinal unicentric study on triage negative ART patients (n = 516) and clinical staff (n = 30) was carried out. We analyzed 705 serological tests for SARS-CoV-2 sampled between 17 May 2020 (the first working day after lockdown release) up to 1 December 2020, to assess the positivity rates for SARS-CoV-2 antibodies. PARTICIPANTS/MATERIALS, SETTING, METHODS We collected data on the serological status for IgM and IgG antibodies against SARS-CoV-2 in 516 triage-negative men (n = 123) and women (n = 393) undergoing ART at a private fertility center and 30 HCWs that were at work during the study period. Antibodies were detected with a capture chemiluminescence assay (CLIA) targeting the highly Immunogenic S1 and S2 domains on the virus spike protein. We also analyzed the molecular test results of the cases exhibiting a positive serology. MAIN RESULTS AND THE ROLE OF CHANCE The data showed that 5.2% of the triage-negative ART patients had a positive serological result for SARS-CoV-2, with an overall conversion rate of 2.1% for IgG and 4.6% for IgM. There was no significant difference in seroprevalence between sexes. The small cohort (n = 30) of HCWs had a markedly increased seroprevalence (12.9% for Ig M and 22.6% for IgG). The highest seropositivity in our cohort was recorded in November (16.2%). The IgM positivity rates revealed significant monthly increments, paralleling official prevalence rates based on nasopharyngeal swabs. No positive molecular tests were identified in cases exhibiting a solitary positive IgG result. We show that despite a 6-fold increase in the number of ART patients with a positive serology between May and December 2020, most of our patients remain unexposed to the virus. The study was undertaken in a high-risk area for COVID-19, with a 20-times increase in the active cases across the study period. LIMITATIONS, REASONS FOR CAUTION The geographical restriction, alongside the lack of running a second, differently-targeted immunoassay (orthogonal testing), could limit the generalizability and translation of our results to other fertility settings or other immunoassays. WIDER IMPLICATIONS OF THE FINDINGS The low positivity rates for IgG against the SARS-CoV-2 spike protein seen at the end of 2020 imply that most of the fertility patients are still at risk for SARS-CoV-2 infection. Until mass vaccination and other measures effectively diminish the pandemic, risk mitigation strategies must be maintained in the fertility units in the foreseeable future. Patients with a solitary IgG+ status are most likely ‘non-infectious’ and can elude further testing without giving up the strict use of universal protective measures. With increasing seroprevalences owing to infection or vaccination, and with the consecutive increase in test performance, it is possible that serological screening of ART patients might be more cost-effective than PCR testing, especially for the many patients with repeat treatments/procedures in a time-frame of months. STUDY FUNDING/COMPETING INTERESTS This research received no external funding. All authors declare having no conflict of interest with regard to this trial.
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Affiliation(s)
- Corina Manolea
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.,Department of Assisted Reproduction, Columna Medical Center, Bucharest, Romania
| | - Andrei Capitanescu
- Hemodialysis Unit, 'Marie Curie' Pediatric Clinical Emergency Hospital, Bucharest, Romania
| | - Roxana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
| | - Ioana Rugescu
- Department of Cells, National Transplant Agency, Bucharest, Romania
| | - Melihan Bechir
- Department of Assisted Reproduction, Columna Medical Center, Bucharest, Romania.,Dept of Obstetrics and Gynecology, Infertility Center, Regina Maria Medical Network, Bucharest, Romania
| | - Claudia Mehedintu
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.,Department of Obstetrics and Gynecology, Nicolae Malaxa Clinical Hospital, Bucharest, Romania
| | - Valentin Varlas
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.,Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
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Carbone L, Mappa I, Sirico A, Di Girolamo R, Saccone G, Di Mascio D, Donadono V, Cuomo L, Gabrielli O, Migliorini S, Luviso M, D'antonio F, Rizzo G, Maruotti GM. Pregnant women's perspectives on severe acute respiratory syndrome coronavirus 2 vaccine. Am J Obstet Gynecol MFM 2021; 3:100352. [PMID: 33771762 PMCID: PMC7985679 DOI: 10.1016/j.ajogmf.2021.100352] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since coronavirus disease 2019 vaccines have been distributed, a debate has raised on whether pregnant women should get the vaccine. No available data exist so far regarding the safety, efficacy, and toxicology of these vaccines when administered during pregnancy. Most of the Obstetrics and Gynecology societies suggested that pregnant could agree to be vaccinated, after a thorough counseling of risks and benefits with their gynecologists, thus leading to an autonomous decision. OBJECTIVE This study aimed to evaluate the attitude to coronavirus disease 2019 vaccination in pregnant and breastfeeding women in Italy. STUDY DESIGN A survey was made at the University of Naples Federico II and the Ospedale Cristo Re, Tor Vergata University of Rome, on pregnant and breastfeeding women asking their perspectives on the available vaccines after reading the recommendations issued by our national Obstetrics, Gynecology, and Neonatology societies. The questionnaire included 12 items finalized to evaluate general features of the women and 6 items specifically correlated to their attitudes toward the severe acute respiratory syndrome coronavirus 2 vaccination. Chi-square or Fisher's exact tests were used to compare group differences of categorical variables and Wilcoxon signed rank or Mann-Whitney U test for continuous variables. The study was approved by the institutional review boards of the University of Naples Federico II (ref. no. 409/2020) and the Ospedale Cristo Re, Tor Vergata University of Rome (ref. #Ost4-2020). RESULTS Most of the included women did not agree to eventually receive severe acute respiratory syndrome coronavirus 2 vaccine during pregnancy (40 [28.2%] vs 102 [71.8%]). Being pregnant was considered a determinant factor to refuse the vaccine prophylaxis (99 [69.7%] vs 43 [30.3%]; chi-square test=24.187; P<.001), even if a very large percentage declared to be generally in favor of vaccines (128 [90.1%] vs 14 [9.9%]; chi-square test=6.091; P=.014) and most of them confirmed they received or would receive other recommended vaccines during pregnancy (75 [52.8%] vs 67 [47.2%]; chi-square test=10.996; P=.001). CONCLUSION Urgent data are needed on the safety, efficacy, and toxicology of severe acute respiratory syndrome coronavirus 2 vaccines during pregnancy to modify this trend and to help obstetricians during the counseling. Furthermore, pregnant women should be included in future vaccine development trials to not incur again in such uncertainty.
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Affiliation(s)
- Luigi Carbone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti).
| | - Ilenia Mappa
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, Tor Vergata University of Rome, Rome, Italy (Drs Mappa, Luviso, and Prof Rizzo)
| | - Angelo Sirico
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
| | - Raffaella Di Girolamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti); Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy (Dr Di Girolamo and Prof D'antonio)
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
| | - Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy (Dr Di Mascio)
| | - Vera Donadono
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
| | - Lara Cuomo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
| | - Olimpia Gabrielli
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
| | - Sonia Migliorini
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
| | - Maria Luviso
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, Tor Vergata University of Rome, Rome, Italy (Drs Mappa, Luviso, and Prof Rizzo)
| | - Francesco D'antonio
- Centre for Fetal Care and High-Risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy (Dr Di Girolamo and Prof D'antonio)
| | - Giuseppe Rizzo
- Division of Maternal Fetal Medicine, Ospedale Cristo Re, Tor Vergata University of Rome, Rome, Italy (Drs Mappa, Luviso, and Prof Rizzo); Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia (Prof Rizzo)
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs Carbone, Sirico, Di Girolamo, Saccone, Donadono, Cuomo, Gabrielli, Migliorini, and Prof Maruotti)
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Liu C, Mu C, Zhang Q, Yang X, Yan H, Jiao H. Effects of Infection with SARS-CoV-2 on the Male and Female Reproductive Systems: A Review. Med Sci Monit 2021; 27:e930168. [PMID: 34193809 PMCID: PMC8259353 DOI: 10.12659/msm.930168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Coronavirus Disease-2019 (COVID-19) is a rapidly spreading pandemic that began at the end of 2019. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Reproductive health has always been one of the most important healthcare problems, and the impacts of COVID-19 on the reproductive systems have become an emerging topic. The effects of infection with SARS-CoV-2 on males are more harmful than on females. The outcomes of pregnancy also can show the condition of male and female reproductive system health. The vertical transmission of SARS-CoV-2 significantly affects pregnancy healthy. SARS-CoV-2, antibody, and other factors, such as the decline of lymphocyte counts, and increased erythrocyte sedimentation rate, C-reactive protein, and D-dimer levels, are evidence of SARS-CoV-2 vertical transmission. Angiotensin-converting enzyme 2 (ACE2) is regarded as a virus receptor in the reproductive system. The expression and activity of ACE2 are influenced by sex hormones, especially the male sex hormones. The strength of immunity is crucial to fighting off viral infection. Antibodies against SARS-CoV-2 show different expression in male and female patients, and the antibodies have been regarded as having potential applications in COVID-19 prevention and treatment. This review aims to present the current status of what is known about the involvement of the male and female reproductive systems, as well as the effects on pregnancy health, during infection with SARS-CoV-2, and discusses the implications for future fertility.
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Affiliation(s)
- Chunlian Liu
- Center for Reproductive Medicine, General Hospital, Ningxia Medical University, Yinchuan, Ningxia, China (mainland).,Key Laboratory of Fertility Preservation and Maintenance, Ministry of Education, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, China (mainland)
| | - Chunlan Mu
- Key Laboratory of Fertility Preservation and Maintenance, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, China (mainland).,Department of Medical Genetics and Cell Biology, Basic Medicine Science College, Ningxia Medical University, Yinchuan, Ningxia, China (mainland)
| | - Qian Zhang
- Center for Reproductive Medicine, General Hospital, Ningxia Medical University, Yinchuan, Ningxia, China (mainland).,Center for Reproductive Medicine, Ningxia Medical University , Yinchuan,Ningxia, China (mainland)
| | - Xiwen Yang
- Key Laboratory of Fertility Preservation and Maintenance, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, China (mainland).,Department of Medical Genetics and Cell Biology, Basic Medicine Science College, Ningxia Medical University, Yinchuan, Ningxia, China (mainland)
| | - Hui Yan
- Center for Reproductive Medicine, General Hospital, Ningxia Medical University, Yinchuan, Ningxia, China (mainland)
| | - Haiyan Jiao
- Key Laboratory of Fertility Preservation and Maintenance, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, China (mainland).,Department of Medical Genetics and Cell Biology, Basic Medicine Science College, Ningxia Medical University, Yinchuan, Ningxia, China (mainland).,Key Laboratory of Reproduction and Genetics in Ningxia, Ningxia Medical University, Yinchuan, Ningxia, China (mainland)
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42
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Chandi A, Jain N. State of ART in the COVID-19 era and consequences on human reproductive system. Biol Reprod 2021; 105:808-821. [PMID: 34159367 DOI: 10.1093/biolre/ioab122] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
The outbreak of the COVID-19 virus has created havoc on the socio-economic aspect of the world. With billions of lives affected by this wrecking pandemic, global fertility services were also not left untouched by its impact. The possibility of sexual transmission of SARS-CoV-2 virus, its impact on male and female fertility, pregnancy, its potential teratogenic effect, and handling of gametes in the clinical laboratories were major concerns among reproductive medicine specialists which led down all the reproductive health services including IUI, IVF/ICSI in most of the countries. Even the people did not intend to conceive during the pandemic crisis and were hesitant to avail such services. Discrete evidence regarding the pathophysiology of COVID-19 infection and its impact on the human reproductive system is not very clear. In this review article, we intend to incorporate all the evidence related to the COVID-19 infection and its impact on human reproduction available to date. It's our responsibility to provide rightful information and to keep our patients familiar with the existing lack of clear evidence. In this COVID-19 era, it's important that the fertility management be prioritized in sub-fertile couples with diminished fertility reserve, and high-risk conditions like malignancies, that may affect their long-term fertility prospects.
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Affiliation(s)
- Anadeep Chandi
- PGIMER, Chandigarh, H No 957, Sector 25, Panchkula, Haryana, India
| | - Neelam Jain
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Sector 32, Chandigarh, India
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Anifandis G, Messini CI, Simopoulou M, Sveronis G, Garas A, Daponte A, Messinis IE. SARS-CoV-2 vs. human gametes, embryos and cryopreservation. Syst Biol Reprod Med 2021; 67:260-269. [PMID: 34060390 DOI: 10.1080/19396368.2021.1922537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is an unprecedented global situation, and all countries have adopted their own measurements to mitigate the spread of the virus in the first as well as in the subsequent waves of infection. All measures, especially in the first wave of the pandemic, were in combination with recommendations provided by professional and scientific organizations. Similar measures were applied to specific procedures, such as the management of infertility, including in vitro fertilization-embryo transfer (IVF-ET) treatments. Although there is no clear scientific evidence yet that the SARS-CoV-2 may exert negative effects on IVF outcome, especially at the early stages, several clinical reports indicate that the virus may impact male fertility through specific receptors presented at the somatic cells of the testis and used by the virus in order to gain entry to the respective cells. Nevertheless, it is not unreasonable to suspect that the virus may affect sperm function as well as oocyte performance directly through specific receptors or indirectly through other signaling pathways. Despite the good practice of IVF laboratory techniques, culture media may also be contaminated during equilibration when airborne virus's particles can contaminate culture media from an already infected embryology area or staff. Furthermore, although there is no clinical evidence, liquid nitrogen could be a route of infection for gametes and embryos when it has been contaminated during production or transportation. Therefore, cryopreservation of gametes and embryos must be virus-free. This communication aims to provide some aspects of the possible impact of the virus on gametes and embryos and how it may affect the cryopreservation procedures.Abbreviations: ACE2: angiotensin- converting enzyme 2; ART: assisted reproductive technology; ASRM: American Society for Reproductive Medicine; CDC: Centers for Disease Control and Prevention; COVID-19: coronavirus disease 2019; ESHRE: European Society of Human Reproduction and Embryology; ET: embryo transfer; FSH: follicle stimulating hormone; IFFS: International Federation of Fertility Societies; IVF: in vitro fertilization; LH: luteinizing hormone; LN: liquid nitrogen; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; T: testosterone; WHO: World Health Organization.
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Affiliation(s)
- George Anifandis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Christina I Messini
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Mara Simopoulou
- Department of Physiology, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - George Sveronis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.,Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Antonios Garas
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Alexandros Daponte
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Ioannis E Messinis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Anifandis G, Tempest HG, Oliva R, Swanson GM, Simopoulou M, Easley CA, Primig M, Messini CI, Turek PJ, Sutovsky P, Ory SJ, Krawetz SA. COVID-19 and human reproduction: A pandemic that packs a serious punch. Syst Biol Reprod Med 2021; 67:3-23. [PMID: 33719829 DOI: 10.1080/19396368.2020.1855271] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic has led to a worldwide health emergency that has impacted 188 countries at last count. The rapid community transmission and relatively high mortality rates with COVID-19 in modern times are relatively unique features of this flu pandemic and have resulted in an unparalleled global health crisis. SARS-CoV-2, being a respiratory virus, mainly affects the lungs, but is capable of infecting other vital organs, such as brain, heart and kidney. Emerging evidence suggests that the virus also targets male and female reproductive organs that express its main receptor ACE2, although it is as yet unclear if this has any implications for human fertility. Furthermore, professional bodies have recommended discontinuing fertility services during the pandemic such that reproductive services have also been affected. Although increased safety measures have helped to mitigate the propagation of COVID-19 in a number of countries, it seems that there is no predictable timeline to containment of the virus, a goal likely to remain elusive until an effective vaccine becomes available and widely distributed across the globe. In parallel, research on reproduction has been postponed for obvious reasons, while diagnostic tests that detect the virus or antibodies against it are of vital importance to support public health policies, such as social distancing and our obligation to wear masks in public spaces. This review aims to provide an overview of critical research and ethics issues that have been continuously emerging in the field of reproductive medicine as the COVID-19 pandemic tragically unfolds.Abbreviations: ACE2: angiotensin- converting enzyme 2; ART: Assisted reproductive technology; ASRM: American Society for Reproductive Medicine; CCR9: C-C Motif Chemokine Receptor 9; CDC: Centers for Disease Control and Prevention; COVID-19: Coronavirus disease 2019; Ct: Cycle threshold; CXCR6: C-X-C Motif Chemokine Receptor 6; ELISA: enzyme-linked immunosorbent assay; ESHRE: European Society of Human Reproduction and Embryology; ET: Embryo transfer; FSH: Follicle Stimulating Hormone; FFPE: formalin fixed paraffin embedded; FYCO1: FYVE And Coiled-Coil Domain Autophagy Adaptor 1; IFFS: International Federation of Fertility Societies; IUI: Intrauterine insemination; IVF: In vitro fertilization; LH: Luteinizing Hormone; LZTFL1: Leucine Zipper Transcription Factor Like 1; MAR: medically assisted reproduction services; MERS: Middle East Respiratory syndrome; NGS: Next Generation Sequencing; ORF: Open Reading Frame; PPE: personal protective equipment; RE: RNA Element; REDa: RNA Element Discovery algorithm; RT-PCR: Reverse=trascriptase transcriptase-polymerase chain reaction; SARS: Severe acute respiratory syndrome; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; SLC6A20: Solute Carrier Family 6 Member 20; SMS: Single Molecule Sequencing; T: Testosterone; TMPRSS2: transmembrane serine protease 2; WHO: World Health Organization; XCR1: X-C Motif Chemokine Receptor.
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Affiliation(s)
- George Anifandis
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Helen G Tempest
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Biomolecular Sciences Institute, Florida International University, Miami, FL, USA
| | - Rafael Oliva
- Molecular Biology of Reproduction and Development Research Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universitat De Barcelona, and Hospital Clinic from Barcelona, Spain
| | - Grace M Swanson
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mara Simopoulou
- Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece, Athens, Greece
| | - Charles A Easley
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA.,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Michael Primig
- Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail), Rennes, France
| | - Christina I Messini
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Paul J Turek
- It is a private Clinic, The Turek Clinic, Beverly Hills, CA, USA
| | - Peter Sutovsky
- Division of Animal Sciences and the Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO, USA
| | - Steve J Ory
- It is a private Clinic, IVF Florida Reproductive Institutes, Margate, FL, USA.,Department of Obstetrics and Gynecology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Obstetrics and Gynecology and Center of Molecular Medicine and Genetics, C.S. Mott Center for Human Growth and Development, Wayne State University, Detroit, MI, USA
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Gingold JA, Galperin S, Fowler S, Kappy M, Pollack S, Singh M, Lieman H, Jindal S. Early experience with universal SARS-CoV-2 testing in a New York-based reproductive endocrinology practice. Syst Biol Reprod Med 2021; 67:144-150. [PMID: 33726574 DOI: 10.1080/19396368.2021.1884317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The SARS-CoV-2 pandemic peak around March 2020 led to temporary closures of most fertility clinics. Many clinics reopened but required universal SARS-CoV-2 screening. However, the rate of positive results and the necessity for such testing is unknown. We report here on early results from asingle-center academic NewYork fertility practice utilizing universal SARS-CoV-2 screening. This mixed prospective retrospective cohort included 164 patients who underwent at least one SARS-CoV-2 screening test for fertility treatment between May and July2020. Patients completed 1 to 3 nasopharyngeal SARS-CoV-2 tests per cycle and remained symptom-free to continue fertility treatments. SARS-CoV-2 test results, past results, history of Covid-19 infection, and patient/cycle characteristics were recorded and tabulated through October2020. Outcomes included positive SARS-CoV-2 RNA tests, rate of prior Covid-19 infections, and clinical courses of patients testing positive. Patients underwent 263 cycles entailing 460 total SARS-CoV-2 screening tests. Fifteen patients reported astrong prior clinical history of Covid-19. Six patients experienced apositive SARS-CoV-2 test (2.3% of all cycles). Among 77 cycles (n = 58 patients) entailing one SARS-CoV-2 test, 2 cases (2.6%) were noted. Among 173 cycles (n = 121 patients) entailing two SARS-CoV-2 tests, 4 cycles (2.3%) were noted. Zero (0%) of 13 cycles (n = 13 patients) entailing 3 SARS-CoV-2 tests were positive. All patients were cleared to resume treatment within one month. Overall, anew asymptomatic infection was identified in 2 cycles (0.8%), while 4 of the 6 positive SARS-CoV-2 tests were among patients with aprior history of Covid-19. 3 of 4 also had adocumented prior positive RNA test. Our data suggest that universal SARS-CoV-2 screening among fertility patients is feasible, with an approximately 2% positive rate per cycle among the patients of this study. Most positive patients had aprior remote infection, but their infectiousness while being screened remains unclear.Abbreviations: REI: reproductive endocrinology and infertility; IUI: intrauterine insemination; IVF: in vitro fertilization; sono: sonography; cryo: cryopreservation; FET: frozen embryo transfer.
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Affiliation(s)
- Julian A Gingold
- Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.,Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA
| | - Sharon Galperin
- School of Medicine, Albert Einstein College of Medicine, Bronx, NY USA
| | - Sabrina Fowler
- School of Medicine, Albert Einstein College of Medicine, Bronx, NY USA
| | - Michelle Kappy
- Department of OB/GYN and Women's Health, Montefiore Medical Center, Bronx, NY, USA
| | - Staci Pollack
- Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.,Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA.,Department of OB/GYN and Women's Health, Montefiore Medical Center, Bronx, NY, USA
| | - Manvinder Singh
- Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.,Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA.,Department of OB/GYN and Women's Health, Montefiore Medical Center, Bronx, NY, USA
| | - Harry Lieman
- Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.,Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA.,Department of OB/GYN and Women's Health, Montefiore Medical Center, Bronx, NY, USA
| | - Sangita Jindal
- Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.,Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA.,Department of OB/GYN and Women's Health, Montefiore Medical Center, Bronx, NY, USA
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46
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Rajput SK, Khan SA, Goheen BB, Engelhorn HJ, Logsdon DM, Grimm CK, Kile RA, West RC, Yuan Y, Schoolcraft WB, McCormick S, Krisher RL, Swain JE. Absence of SARS-CoV-2 (COVID-19 virus) within the IVF laboratory using strict patient screening and safety criteria. Reprod Biomed Online 2021; 42:1067-74. [PMID: 33814309 DOI: 10.1016/j.rbmo.2021.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 12/17/2022]
Abstract
Research question Is there a risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral exposure and potential cross-contamination from follicular fluid, culture media and vitrification solution within the IVF laboratory using strict patient screening and safety measures? Design This was a prospective clinical study. All women undergoing transvaginal oocyte retrieval were required to have a negative SARS-CoV-2 RNA test 3–5 days prior to the procedure. Male partners were not tested. All cases used intracytoplasmic sperm injection (ICSI). The first tube of follicular fluid aspirated during oocyte retrieval, drops of media following removal of the embryos on day 5, and vitrification solution after blastocyst cryopreservation were analysed for SARS-CoV-2 RNA. Results In total, medium from 61 patients, vitrification solution from 200 patients and follicular fluid from 300 patients was analysed. All samples were negative for SARS-CoV-2 viral RNA. Conclusions With stringent safety protocols in place, including testing of women and symptom-based screening of men, the presence of SARS-CoV-2 RNA was not detected in follicular fluid, medium or vitrification solution. This work demonstrates the possibility of implementing a rapid laboratory screening assay for SARS-CoV-2 and has implications for safe laboratory operations, including cryostorage recommendations.
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47
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Bruinvels G, Lewis NA, Blagrove RC, Scott D, Simpson RJ, Baggish AL, Rogers JP, Ackerman KE, Pedlar CR. COVID-19-Considerations for the Female Athlete. Front Sports Act Living 2021; 3:606799. [PMID: 33665612 PMCID: PMC7921484 DOI: 10.3389/fspor.2021.606799] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/22/2021] [Indexed: 01/10/2023] Open
Abstract
The SARS CoV-2 virus (COVID-19) caused the whole sporting calendar to be paused. As we embark on the challenge of navigating through the return to play (RTP) process, there is a necessity to consider the needs of all athletes. This commentary specifically considers recommendations and requirements for the female athlete with a physiological emphasis during and following the COVID-19 pandemic, however, it will be relevant for any similar future scenarios that may present. It is important to acknowledge that there remain many unknowns surrounding COVID-19 and the female athlete both in the short- and long-term.
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Affiliation(s)
- Georgie Bruinvels
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Orreco Ltd., Unit 103, Business Innovation Centre, NUI Galway, Galway, Ireland
| | - Nathan A Lewis
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Orreco Ltd., Unit 103, Business Innovation Centre, NUI Galway, Galway, Ireland
| | - Richard C Blagrove
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Dawn Scott
- School of Science and Health, University of Western Sydney, Penrith, NSW, Australia
| | - Richard J Simpson
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, United States.,Department of Pediatrics, University of Arizona, Tucson, AZ, United States.,Department of Immunobiology, University of Arizona, Tucson, AZ, United States
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA, United States
| | - John P Rogers
- Department of Sports Medicine, Manchester Institute of High Performance, Manchester, United Kingdom.,Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Kathryn E Ackerman
- Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
| | - Charles R Pedlar
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom.,Orreco Ltd., Unit 103, Business Innovation Centre, NUI Galway, Galway, Ireland
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48
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Bhattacharya S, Maheshwari A, Ratna MB, van Eekelen R, Mol BW, McLernon DJ. Prioritizing IVF treatment in the post-COVID 19 era: a predictive modelling study based on UK national data. Hum Reprod 2021; 36:666-675. [PMID: 33226080 PMCID: PMC7717242 DOI: 10.1093/humrep/deaa339] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/13/2020] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Can we use prediction modelling to estimate the impact of coronavirus disease 2019 (COVID 19) related delay in starting IVF or ICSI in different groups of women? SUMMARY ANSWER Yes, using a combination of three different models we can predict the impact of delaying access to treatment by 6 and 12 months on the probability of conception leading to live birth in women of different age groups with different categories of infertility. WHAT IS KNOWN ALREADY Increased age and duration of infertility can prejudice the chances of success following IVF, but couples with unexplained infertility have a chance of conceiving naturally without treatment whilst waiting for IVF. The worldwide suspension of IVF could lead to worse outcomes in couples awaiting treatment, but it is unclear to what extent this could affect individual couples based on age and cause of infertility. STUDY DESIGN, SIZE, DURATION A population based cohort study based on national data from all licensed clinics in the UK obtained from the Human Fertilisation and Embryology Authority Register. Linked data from 9589 women who underwent their first IVF or ICSI treatment in 2017 and consented to the use of their data for research were used to predict livebirth numbers. PARTICIPANTS/MATERIALS, SETTING, METHODS Three prediction models were used to estimate the chances of livebirth associated with immediate treatment versus a delay of 6 and 12 months in couples about to embark on IVF or ICSI. MAIN RESULTS AND THE ROLE OF CHANCE We estimated that a 6-month delay would reduce livebirths by 0.4%, 2.4%, 5.7%, 9.5% and 11.8% in women aged <30, 30-35, 36-37, 38-39 and 40-42 years, respectively, while corresponding values associated with a delay of 12 months were 0.9%, 4.9%, 11.9%, 18.8% and 22.4%, respectively. In women with known causes of infertility, worst case (best case) predicted chances of livebirth after a delay of 6 months in women aged <30, 30-35, 36-37, 38-39 and 40-42 years varied between 31.6% (35.0%), 29.0% (31.6%), 23.1% (25.2%), 17.2% (19.4%) and 10.3% (12.3%) for tubal infertility and 34.3% (39.2%), 31.6% (35.3%) 25.2%(28.5%) 18.3% (21.3%), and 11.3% (14.1%) for male factor infertility. The corresponding values in those treated immediately were 31.7%, 29.8%, 24.5%, 19.0% and 11.7% for tubal factor and 34.4%, 32.4%, 26.7%, 20.2% and 12.8% in male factor infertility. In women with unexplained infertility the predicted chances of livebirth after a delay of 6 months followed by one complete IVF cycle were 41.0%, 36.6%, 29.4%, 22.4% and 15.1% in women aged <30, 30-35, 36-37, 38-39 and 40-42 years, respectively, compared to 34.9%, 32.5%, 26.9%, 20.7% and 13.2% in similar groups of women treated without any delay. The additional waiting period, which provided more time for spontaneous conception, was predicted to increase the relative number of babies born by 17.5%, 12.6%, 9.1%, 8.4% and 13.8%, in women aged <30, 30-35, 36-37, 38-39 and 40-42 years, respectively. A 12-month delay showed a similar pattern in all subgroups. LIMITATIONS, REASONS FOR CAUTION Major sources of uncertainty include the use of prediction models generated in different populations and the need for a number of assumptions. Although the models are validated and the bases for the assumptions are robust, it is impossible to eliminate the possibility of imprecision in our predictions. Therefore, our predicted live birth rates need to be validated in prospective studies to confirm their accuracy. WIDER IMPLICATIONS OF THE FINDINGS A delay in starting IVF reduces success rates in all couples. For the first time, we have shown that while this results in fewer babies in older women and those with a known cause of infertility, it has a less detrimental effect on couples with unexplained infertility, some of whom conceive naturally whilst waiting for treatment. Post COVID 19, clinics planning a phased return to normal clinical services should prioritise older women and those with a known cause of infertility. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received for this study. B.W.M. is supported by an NHMRC Practitioner Fellowship (GNT1082548) and reports consultancy work for ObsEva, Merck, Merck KGaA, Guerbet and iGenomics. SB is Editor-in-Chief of Human Reproduction Open. None of the other authors declare any conflicts of interest.
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Affiliation(s)
| | - Abha Maheshwari
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Mariam Begum Ratna
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Rik van Eekelen
- Centre for Reproductive Medicine, Academic Medical Centre University of Amsterdam, Amsterdam, Netherlands
| | - Ben Willem Mol
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK.,Department of Obstetrics & Gynaecology, Monash University, Monash Medical Centre, Clayton, VIC, Australia
| | - David J McLernon
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
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Cirillo M, Rizzello F, Badolato L, De Angelis D, Evangelisti P, Coccia ME, Fatini C. The effects of COVID-19 lockdown on lifestyle and emotional state in women undergoing assisted reproductive technology: Results of an Italian survey. J Gynecol Obstet Hum Reprod 2021; 50:102079. [PMID: 33545410 PMCID: PMC8060062 DOI: 10.1016/j.jogoh.2021.102079] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/09/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE On March 8, 2020, the Italian Government implemented extraordinary measures to limit viral transmission of COV-19/SARS-CoV-2. We evaluated the impact of COVID-19 lockdown on lifestyle and emotional state in women planning infertility treatments. BASIC PROCEDURES We performed a quantitative research study using a web-based survey, in 140 women referred to Assisted Reproductive Technologies Center. MAIN FINDINGS We observed changes in body weight during lockdown in 80 % of women, and a significant increase in BMI in comparison to that observed before (p=.001). We observed a high percentage of non-adherence to the Mediterranean pattern during lockdown due to higher frequency of consumption of sweet/pastries, cheese and meat, rather than fruit, vegetables and legumes. Before lockdown 36.4 % women were snack consumers while during lockdown 55 % (p=.002). By considering individuals' attitude to snack consumption, we observed an increase related to boredom (p=<.0001) and anxiety (p=.05) during lockdown. Increased levels of anxiety and sadness were observed in about 30 %, and of boredom in 25 %. The percentage of women worried about their planning infertility treatment was more than 50 %. PRINCIPAL CONCLUSIONS Quarantine-related restrictions strongly influenced lifestyle psychological behavior leading to an increased burden of cardiovascular disease.
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Affiliation(s)
- Michela Cirillo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Francesca Rizzello
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Laura Badolato
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Denise De Angelis
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Paolo Evangelisti
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Maria Elisabetta Coccia
- Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy; Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| | - Cinzia Fatini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy.
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50
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Rajput SK, Logsdon DM, Kile B, Engelhorn HJ, Goheen B, Khan S, Swain J, McCormick S, Schoolcraft WB, Yuan Y, Krisher RL. Human eggs, zygotes, and embryos express the receptor angiotensin 1-converting enzyme 2 and transmembrane serine protease 2 protein necessary for severe acute respiratory syndrome coronavirus 2 infection. F S Sci 2021; 2:33-42. [PMID: 33521687 PMCID: PMC7831752 DOI: 10.1016/j.xfss.2020.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To study messenger ribonucleic acid (mRNA) and protein expressions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptors (angiotensin 1-converting enzyme 2 [ACE2] and CD147) and proteases (transmembrane serine protease 2 [TMPRSS2] and cathepsin L [CTSL]) in human oocytes, embryos, and cumulus (CCs) and granulosa cells (GCs). DESIGN Research study. SETTING Clinical in vitro fertilization (IVF) treatment center. PATIENTS Patients undergoing IVF were treated at the Colorado Center for Reproductive Medicine. INTERVENTIONS Oocytes (germinal vesicle and metaphase II [MII]) and embryos (1-cell [1C] and blastocyst [BL]) were donated for research at the disposition by the patients undergoing IVF. Follicular cells (CC and GC) were collected from women undergoing egg retrieval after ovarian stimulation without an ovulatory trigger for in vitro maturation/IVF treatment cycles. MAIN OUTCOME MEASURES Presence or absence of ACE2, CD147, TMPRSS2, and CTSL mRNAs detected using quantitative reverse transcription polymerase chain reaction and proteins detected using capillary Western blotting in human oocytes, embryos, and ovarian follicular cells. RESULTS The quantitative reverse transcription polymerase chain reaction analysis revealed high abundance of ACE2 gene transcripts in germinal vesicle and MII oocytes than in CC, GC, and BL. ACE2 protein was present only in the MII oocytes, and 1C and BL embryos, but other ACE2 protein variants were observed in all the samples. TMPRSS2 protein was present in all the samples, whereas mRNA was observed only in the BL stage. All the samples were positive for CD147 and CTSL mRNA expressions. However, CCs and GCs were the only samples that showed coexpression of both CD147 and CTSL proteins in low abundance. CONCLUSIONS CCs and GCs are the least susceptible to SARS-CoV-2 infection because of lack of the required combination of receptors and proteases (ACE2/TMPRSS2 or CD147/CTSL) in high abundance. The coexpression of ACE2 and TMPRSS2 proteins in the MII oocytes, zygotes, and BLs demonstrated that these gametes and embryos have the cellular machinery required and, thus, are potentially susceptible to SARS-CoV-2 infection if exposed to the virus. However, we do not know whether the infection occurs in vivo or in vitro in an assisted reproductive technology setting yet.
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Affiliation(s)
| | | | - Becca Kile
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | | | - Ben Goheen
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Shaihla Khan
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Jason Swain
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Sue McCormick
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | | | - Ye Yuan
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Rebecca L Krisher
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
- Genus PLC, DeForest, Wisconsin
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