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Al-Bdairi AA, Makki HA, Shawki O, Alkhudair SH, Al-Hilli NM, Alkhalidi BA, Alkadhim HK, Shweliyya AA. The Multi-faceted Effects of COVID-19 on Female Reproductive Health: An Updated Narrative Review. Cureus 2024; 16:e57944. [PMID: 38738039 PMCID: PMC11082527 DOI: 10.7759/cureus.57944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
Concerns about the SARS-CoV-2 pandemic's possible impact on sexual and reproductive health have grown significantly. In this narrative review, the latest research on the effects of SARS-CoV-2 infection on several facets of sexual and reproductive health is reviewed. The review starts initially by going through the possible consequences of SARS-CoV-2 on female menstrual cycles. The virus may interfere with the menstrual cycle, which could affect hormone synthesis and endometrial reactions, according to newly available evidence. Menstrual blood loss may be impacted by COVID-19's potential to influence endothelial cell function and systemic hemostasis. Hypothalamic amenorrhea may be brought on by severe COVID-19 disease. There is little research on this subject, although most women resume their regular menstrual cycles after 1-2 months of recuperation. The review also examines how SARS-CoV-2 infection may affect assisted reproductive technology (ART) treatments. There are few clinical data, although some research points to potential effects on embryo quality. Overall, ART results, however, did not materially change from the time before the epidemic. Obstetric problems are more likely when SARS-CoV-2 infection occurs during pregnancy, especially in the third trimester. Even though the maternal death rate is still low, pregnant women, especially those with comorbidities, are more likely to experience serious sickness. The review emphasizes how the COVID-19 vaccine affects menstrual cycles, showing brief, modest modifications without serious health hazards. Also included are the psychological effects of family planning choices during the pandemic. In conclusion, this narrative review offers a thorough assessment of the complicated and changing effects of SARS-CoV-2 on sexual and reproductive health. The different requirements of people and couples during and after the pandemic are highlighted, underscoring the necessity for ongoing study and specialized healthcare practices.
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Affiliation(s)
- Adnan A Al-Bdairi
- Infertility, Assisted Reproductive Technologies, Teba IVF and Genetic Center, Babylon, IRQ
| | - Hayder A Makki
- Pharmacology and Toxicology, College of Pharmacy, University of Babylon, Babylon, IRQ
| | - Osama Shawki
- Gynecology Surgery, School of Medicine, Cairo University, Cairo, EGY
| | - Sallama H Alkhudair
- Fertility, Assisted Reproductive Technology, Alzaitoon Specialized Fertility Center, Baghdad, IRQ
| | - Nadia M Al-Hilli
- Obstetrics and Gynecology, College of Medicine, University of Babylon, Babylon, IRQ
| | - Batool A Alkhalidi
- Obstetrics and Gynecology, College of Medicine, University of Kufa, Najaf, IRQ
| | - Hanan K Alkadhim
- Obstetrics and Gynecology, Iraqi Fertility Society, College of Medicine, University of Babylon, Babylon, IRQ
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Lin C, Li M, Lin Y, Zhang Y, Xu H, Chen B, Yan X, Xu Y. Impact of plasma Epstein-Barr virus DNA in posttreatment nasopharyngeal carcinoma patients after SARS-CoV-2 infection. Infect Agent Cancer 2024; 19:8. [PMID: 38486290 PMCID: PMC10938826 DOI: 10.1186/s13027-024-00570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is prevalent in southern China. EBV DNA is the most useful biomarker in NPC. However, the value of EBV DNA in posttreatment NPC patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. METHODS Sixty-four eligible NPC patients were enrolled between December 2022 and February 2023. Patients who met the following criteria were included: had non-metastatic NPC, completed radical treatment, were first firstly infected with SARS-CoV-2 and their EBV DNA changed from undetectable to detectable. RESULTS At the end of follow-up, 81.25% (52/64) of patients were confirmed not to relapse with undetectable EBV DNA (no-relapse). In addition, 18.75% (12/64) of patients experienced relapse with consistent detection of EBV DNA (yes-relapse). For all 64 patients, the average time from diagnosis of coronavirus disease 2019 (COVID-19) to detection of detectable EBV DNA was 35.41 days (2 to 139 days). For 52 no-relapse patients, the average time from EBV DNA changing from detectable to undetectable was 63.12 days (6 to 147 days). The levels of EBV DNA were greater in yes-relapse patients than that in no-relapse patients, and the average of EBV DNA levels were 1216 copies/ml and 53.18 copies/ml, respectively. Using 62.3 copies/mL as the threshold, the area under the curve for EBV DNA was 0.88 for distinguishing yes-relapse patients from no-relapse patients. The sensitivity and specificity were 81.97% (95% CI 0.71-0.95) and 86.67% (95% CI 0.70-0.95), respectively. CONCLUSION For NPC patients infected with SARS-CoV-2, EBV DNA alone is insufficient for monitoring relapse after radical therapy. Long-term follow-up and underlying mechanistic investigations of EBV DNA changes are urgently needed.
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Affiliation(s)
- Cheng Lin
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
- Interdisciplinary College of Medicine and Engineering, Fuzhou University, Fuzhou, Fujian, China
| | - Meifang Li
- Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yingying Lin
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yu Zhang
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Hanchuan Xu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Bijuan Chen
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Xia Yan
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yun Xu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
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Calvet GA, Kara E, Gonsalves L, Seuc AH, de Oliveira RDVC, Thwin SS, Gomez Ponce de León R, Gámez MC, Peña GM, Pendás BVR, Alzugaray MG, Carballo GO, Cala DC, Guimarães PMQ, Bonet M, Taylor M, Thorson A, Kim C, Ali M, Broutet N. Viral shedding of SARS-CoV-2 in body fluids associated with sexual activity: a systematic review and meta-analysis. BMJ Open 2024; 14:e073084. [PMID: 38387982 PMCID: PMC10882346 DOI: 10.1136/bmjopen-2023-073084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE To identify and summarise the evidence on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection and persistence in body fluids associated with sexual activity (saliva, semen, vaginal secretion, urine and faeces/rectal secretion). ELIGIBILITY All studies that reported detection of SARS-CoV-2 in saliva, semen, vaginal secretion, urine and faeces/rectal swabs. INFORMATION SOURCES The WHO COVID-19 database from inception to 20 April 2022. RISK OF BIAS ASSESSMENT The National Institutes of Health tools. SYNTHESIS OF RESULTS The proportion of patients with positive results for SARS-CoV-2 and the proportion of patients with a viral duration/persistence of at least 14 days in each fluid was calculated using fixed or random effects models. INCLUDED STUDIES A total of 182 studies with 10 023 participants. RESULTS The combined proportion of individuals with detection of SARS-CoV-2 was 82.6% (95% CI: 68.8% to 91.0%) in saliva, 1.6% (95% CI: 0.9% to 2.6%) in semen, 2.7% (95% CI: 1.8% to 4.0%) in vaginal secretion, 3.8% (95% CI: 1.9% to 7.6%) in urine and 31.8% (95% CI: 26.4% to 37.7%) in faeces/rectal swabs. The maximum viral persistence for faeces/rectal secretions was 210 days, followed by semen 121 days, saliva 112 days, urine 77 days and vaginal secretions 13 days. Culturable SARS-CoV-2 was positive for saliva and faeces. LIMITATIONS Scarcity of longitudinal studies with follow-up until negative results. INTERPRETATION SARS-CoV-2 RNA was detected in all fluids associated with sexual activity but was rare in semen and vaginal secretions. Ongoing droplet precautions and awareness of the potential risk of contact with faecal matter/rectal mucosa are needed. PROSPERO REGISTRATION NUMBER CRD42020204741.
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Affiliation(s)
| | - Edna Kara
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Lianne Gonsalves
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Armando Humberto Seuc
- National Institute of Hygiene Epidemiology and Microbiology, Habana, La Habana, Cuba
| | | | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | - Mercedes Bonet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Melanie Taylor
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Caron Kim
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Moazzam Ali
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Nathalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Stark J, Kuster SP, Hungerbühler V. Impact of COVID-19 disease on the male factor in reproductive medicine - how-to advise couples undergoing IVF/ICSI. Reprod Fertil Dev 2024; 36:RD23205. [PMID: 38185121 DOI: 10.1071/rd23205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
CONTEXT The COVID-19 pandemic has caused widespread concern about its potential impact on various aspects of human health. AIMS This narrative review aims to summarise the current knowledge about the impact of COVID-19 on sperm quality and its effect on assisted reproductive technology. METHODS In this narrative review, a literature search using the PubMed and MEDLINE databases was conducted to identify relevant original research articles published up to 29 January 2023. RESULTS Thirty original studies were included in our review. There is evidence that SARS-CoV-2 is detectable in seminal fluid during the acute phase of infection and for up to 1month. However, the fact that SARS-CoV-2 is barely detectable in semen makes sexual transmission very unlikely. COVID-19 infection has been associated with the following changes in sperm quality: morphology, altered motility, changed DNA fragmentation-index (DFI), decreased sperm concentration, lower total number of sperm, and a significant increase in leukocytes and cytokines. The effects mostly seem to be reversible and have not been shown to negatively affect the outcome of assisted reproductive technology but should lead to further research concerning the health of the offspring, because a correlation of increased DFI after COVID-19 even 5months after disease could be assumed. CONCLUSIONS The findings of this narrative review suggest that SARS-CoV-2 may harm sperm quality in the acute phase. IMPLICATIONS A recovery time of at least 3months regarding assisted reproductive therapy could be reasonable.
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Affiliation(s)
- Julia Stark
- Kantonsspital St. Gallen, Department of Gynecological Endocrinology and Reproductive Medicine, St. Gallen, Switzerland
| | - Stefan P Kuster
- Kantonsspital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacher Str. 95, 9007 St. Gallen, Switzerland
| | - Vera Hungerbühler
- Kantonsspital St. Gallen, Department of Gynecological Endocrinology and Reproductive Medicine, Fiore Praxis AG, Brauerstrasse 95, 9016 St. Gallen, Switzerland
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Kalfas T, Kaltsas A, Symeonidis EN, Symeonidis A, Zikopoulos A, Moustakli E, Tsiampali C, Tsampoukas G, Palapela N, Zachariou A, Sofikitis N, Dimitriadis F. COVID-19 and Male Infertility: Is There a Role for Antioxidants? Antioxidants (Basel) 2023; 12:1483. [PMID: 37627478 PMCID: PMC10451649 DOI: 10.3390/antiox12081483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/14/2023] [Accepted: 07/22/2023] [Indexed: 08/27/2023] Open
Abstract
Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), jeopardizes male fertility because of the vulnerability of the male reproductive system, especially the testes. This study evaluates the effects of the virus on testicular function and examines the potential role of antioxidants in mitigating the damage caused by oxidative stress (OS). A comprehensive PubMed search examined exocrine and endocrine testicular function alteration, the interplay between OS and COVID-19-induced defects, and the potential benefit of antioxidants. Although the virus is rarely directly detectable in sperm and testicular tissue, semen quality and hormonal balance are affected in patients, with some changes persisting throughout a spermatogenesis cycle. Testicular pathology in deceased patients shows defects in spermatogenesis, vascular changes, and inflammation. Acute primary hypogonadism is observed mainly in severely infected cases. Elevated OS and sperm DNA fragmentation markers suggest redox imbalance as a possible mechanism behind the fertility changes. COVID-19 vaccines appear to be safe for male fertility, but the efficacy of antioxidants to improve sperm quality after infection remains unproven due to limited research. Given the limited and inconclusive evidence, careful evaluation of men recovering from COVID-19 seeking fertility improvement is strongly recommended.
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Affiliation(s)
| | - Aris Kaltsas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Evangelos N. Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (A.S.)
| | - Asterios Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (A.S.)
| | - Athanasios Zikopoulos
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Efthalia Moustakli
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | | | - Georgios Tsampoukas
- Department of Urology, Oxford University Hospital NHS Trust, Oxford OX3 7LE, UK;
| | - Natalia Palapela
- Medical Faculty, Medical University of Sofia, 1431 Sofia, Bulgaria;
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (A.S.)
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Guiton R, Drevet JR. Viruses, bacteria and parasites: infection of the male genital tract and fertility. Basic Clin Androl 2023; 33:19. [PMID: 37468865 DOI: 10.1186/s12610-023-00193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/05/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Infertility affects one couple out of six worldwide. Male infertilty can result from congenital or acquired factors, of which pathogens that reach the genital tract through sexual contact or blood dissemination. The impact of major viral, bacterial and parasitic infections on the male genital tract and fertility has been summarized. RESULTS AND CONCLUSIONS A systematic review of articles published in the Google Scholar and PubMed databases was conducted. It turns out that viruses, as well as bacteria and parasites are major inducers of male genital tract infections and ensuing infertility through damage to the organs and subsequent loss of function and/or through direct damage to the sperm cells. Moreover, not only male infertility results from such infections but these can also be transmitted to women and even to the offspring, thus highlighting the need to efficiently detect, treat and prevent them.
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Affiliation(s)
- Rachel Guiton
- Université Clermont Auvergne, CNRS UMR6293, GReD Institute, 63001, Clermont-Ferrand, France.
| | - Joël R Drevet
- Université Clermont Auvergne, CNRS UMR6293, GReD Institute, 63001, Clermont-Ferrand, France
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Vasei M, Jafari E, Falah Azad V, Safavi M, Sotoudeh M. Molecular Diagnosis of COVID-19; Biosafety and Pre-analytical Recommendations. IRANIAN JOURNAL OF PATHOLOGY 2023; 18:244-256. [PMID: 37942195 PMCID: PMC10628373 DOI: 10.30699/ijp.2023.1988405.3061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/08/2023] [Indexed: 11/10/2023]
Abstract
From the beginning of the COVID-19 epidemic, clinical laboratories around the world have been involved with tests for detection of SARS-CoV-2. At present, RT-PCR (real-time reverse transcription polymerase chain reaction assay) is seen as the gold standard for identifying the virus. Many factors are involved in achieving the highest accuracy in this test, including parameters related to the pre-analysis stage. Having instructions on the type of sample, how to take the sample, and its storage and transportation help control the interfering factors at this stage. Studies have shown that pre-analytical factors might be the cause of the high SARS-CoV-2 test false-negative rates. Also, the safety of personnel in molecular laboratories is of utmost importance, and it requires strict guidelines to ensure the safety of exposed individuals and prevent the virus from spreading. Since the onset of the outbreak, various instructions and guidelines have been developed in this field by the institutions and the Ministry of Health of each country; these guidelines are seriously in need of integration and operation. In this study, we try to collect all the information and research done from the beginning of this pandemic in December 2019 - August 2022 concerning biosafety and protective measures, sample types, sampling methods, container, and storage solutions, sampling equipment, and sample storage and transportation for molecular testing of SARS-CoV-2.
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Affiliation(s)
- Mohammad Vasei
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Cell-BasedTherapies Research Center, Digestive Disease Research Institute, Shari'ati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Elham Jafari
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Pathology and Stem Cells Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Falah Azad
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Moeinadin Safavi
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sotoudeh
- Molecular Pathology and Cytogenetics Division, Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Depuydt C, Bosmans E, Jonckheere J, Donders F, Ombelet W, Coppens A, Donders G. SARS-CoV-2 infection reduces quality of sperm parameters: prospective one year follow-up study in 93 patients. EBioMedicine 2023; 93:104640. [PMID: 37307756 DOI: 10.1016/j.ebiom.2023.104640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Short- and long-term implications of SARS-CoV-2 on the quality of the sperm and the results of this on fertility remain largely unknown due to lack of longitudinal studies. In this longitudinal observational cohort study, we aimed to analyse the differential effect and the impact of SARS-CoV-2 infection on different semen quality parameters. METHODS Sperm quality was assessed using the World Health Organization criteria, DNA damage to sperm cells by quantifying the DNA fragmentation index (DFI) and the high-density stainability (HDS), IgA- and IgG-anti-sperm antibodies (ASA) were assessed with light microscopy. FINDINGS SARS-CoV-2 infection was associated with sperm parameters that were independent of spermatogenic cycle like progressive motility, morphology, DFI and HDS, as well as spermatogenic cycle dependent parameters such as sperm concentration. Detection of IgA- and IgG-ASA allowed classification of patients in three different groups according to its sequence of appearance in sperm during post-COVID-19 follow-up. The maximum progressive motility was lowest during follow-up in patients without ASA (41.9%), intermediate in patients with only IgA-ASA (46.2%) and highest inpatients who had both IgA- and IgG-ASA (54.9%). INTERPRETATION SARS-CoV-2 infection was associated with changes of all analysed sperm parameters to a different degree which is also observed in their return to normality and is suggestive of individual variations in the patient's immune system performance. Firstly, sperm production is decreased through temporal immune mediated arrest of active meiosis, and secondly immune induced sperm DNA damage prevents fertilization if transferred to the oocyte. Both mechanisms are temporal, and most sperm parameters return to baseline after infection. FUNDING AML (R20-014), Femicare.
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Affiliation(s)
- Christophe Depuydt
- Department of Hormonology and Reproductive Health, Algemeen Medisch Laboratorium (AML), Sonic Healthcare, Antwerp, Belgium; Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, Antwerp, Belgium.
| | - Eugene Bosmans
- Department of Hormonology and Reproductive Health, Algemeen Medisch Laboratorium (AML), Sonic Healthcare, Antwerp, Belgium; Department of Clinical Microbiology, AML, Sonic Healthcare, Antwerp, Belgium
| | - Jef Jonckheere
- Department of Clinical Microbiology, AML, Sonic Healthcare, Antwerp, Belgium
| | | | - Willem Ombelet
- Genk Institute for Fertility Technology, Ziekenhuis Oost-Limburg (ZOL) Hospitals, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Astrid Coppens
- Department of Hormonology and Reproductive Health, Algemeen Medisch Laboratorium (AML), Sonic Healthcare, Antwerp, Belgium; Department of Clinical Microbiology, AML, Sonic Healthcare, Antwerp, Belgium
| | - Gilbert Donders
- Femicare, Clinical Research for Women, Tienen, Belgium; University Hospital Antwerpen, Antwerp, Belgium; Department of Obstetrics and Gynecology, Regional Hospital Heilig Hart, Tienen, Belgium
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9
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Wang S, Zhang A, Pan Y, Liu L, Niu S, Zhang F, Liu X. Association between COVID-19 and Male Fertility: Systematic Review and Meta-Analysis of Observational Studies. World J Mens Health 2023; 41:311-329. [PMID: 36326165 PMCID: PMC10042646 DOI: 10.5534/wjmh.220091] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Whether COVID-19 reduces male fertility remains requires further investigation. This meta-analysis and systematic review evaluated the impact of COVID-19 on male fertility. MATERIALS AND METHODS The literature in PubMed, Embase, MEDLINE, Web of Science, and Cochrane Library up to January 01, 2022 was systematically searched, and a meta-analysis was conducted to investigate the effect of COVID-19 on male fertility. Totally 17 studies with a total of 1,627 patients and 1,535 control subjects were included in our meta-analysis. RESULTS Regarding sperm quality, COVID-19 decreased the total sperm count (p=0.012), sperm concentration (p=0.001), total motility (p=0.001), progressive sperm motility (p=0.048), and viability (p=0.031). Subgroup analyses showed that different control group populations did not change the results. It was found that during the illness stage of COVID-19, semen volume decreased, and during the recovery stage of COVID-19, sperm concentration and total motility decreased <90 days. We found that sperm concentration and total motility decreased during recovery for ≥90 days. Fever because of COVID-19 significantly reduced sperm concentration and progressive sperm motility, and COVID-19 without fever ≥90 days, the sperm total motility and progressive sperm motility decreased. Regarding disease severity, the moderate type of COVID-19 significantly reduced sperm total motility, but not the mild type. Regarding sex hormones, COVID-19 increased prolactin and estradiol. Subgroup analyses showed that during the illness stage, COVID-19 decreased testosterone (T) levels and increased luteinizing hormone levels. A potential publication bias may have existed in our meta-analysis. CONCLUSIONS COVID-19 in men significantly reduced sperm quality and caused sex hormone disruption. COVID-19 had long-term effects on sperm quality, especially on sperm concentration and total motility. It is critical to conduct larger multicenter studies to determine the consequences of COVID-19 on male fertility.
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Affiliation(s)
- Shangren Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Aiqiao Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shuai Niu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fujun Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
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Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
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Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey.,ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
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11
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Garrouch S, Sallem A, Ben Fredj M, Kooli R, Bousabbeh M, Boughzala I, Sriha A, Hajjaji A, Mehdi M. Deleterious impact of COVID-19 pandemic: Male fertility was not out of the bag. PLoS One 2023; 18:e0284489. [PMID: 37155673 PMCID: PMC10166489 DOI: 10.1371/journal.pone.0284489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/31/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND The emergence and the spread of coronavirus disease (COVID-19) induced by the SARS-CoV-2 virus has multiple consequences in all countries around the world. Male germ cells of infertile patients which are shown to be vulnerable to many environmental conditions, could be particularly vulnerable to such an exceptional pandemic situation. We aimed through the current study to investigate the potential variations in sperm quality of infertile patients during the COVID-19 pandemic in Tunisia. METHODS This was a cohort study including 90 infertile patients addressed to Laboratory of Cytogenetics and Reproductive Biology of Monastir Department of Maternity and Neonatology in Monastir, during the two first COVID-19 waves in Tunisia and who already have a spermogram before the pandemic period. RESULTS We have pointed out a significant decrease in both total and progressive sperm motility during COVID-19 pandemic (p<0.0001 and p = 0.001 respectively). The percentage of morphologically abnormal spermatozoa increased from 90.99±7.38 to 93.67±4.55% during the pandemic (p< 0.001). The remaining sperm parameters were similar between the two compared timepoints. Interestingly, the univariate analysis didn't show any other associated factor to the observed impairment in sperm mobility and morphology. CONCLUSION These data highlight the severe impact of the pandemic of the male reproductive health of hypofertile patients. Delaying infertility investigations and management after pandemic waves is recommended to hope a better gamete quality and hence to improve conception potential.
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Affiliation(s)
- Siwar Garrouch
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Amira Sallem
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
- Laboratory of Histology-Embryology and Cytogenetics (LR18ES40), Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bouguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Rim Kooli
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Manel Bousabbeh
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Ines Boughzala
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Asma Sriha
- Department of Epidemiology and Preventive Medicine, Fattouma Bouguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Awatef Hajjaji
- Department of Gynecology and Obstetrics, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
| | - Meriem Mehdi
- Laboratory of Cytogenetics and Reproductive Biology, Maternity and Neonatology Center, Fattouma Bourguiba University Teaching Hospital, Monastir, Tunisia
- Laboratory of Histology-Embryology and Cytogenetics (LR18ES40), Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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12
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Lv Y, Huang X, Xiang Q, Yang Q, Chen J, Cai M, Wang P, Jia P, Wang H, Xie C, Li L, Zhang D, Wei D, Wu J. Effectiveness of enhanced check during acute phase to reduce central venous catheters-associated bloodstream infections: a before-after, real-world study. Antimicrob Resist Infect Control 2022; 11:151. [PMID: 36474305 PMCID: PMC9724293 DOI: 10.1186/s13756-022-01190-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To evaluate the effectiveness of enhanced check to the duration of the central venous catheters associated bloodstream infections (CABSIs), and the impact on infection rates. METHODS A before-after, real-world study in six adult intensive care units was conducted. All adult patients who had only one central venous catheter were included during two consecutive periods. The intervention period, added cross-check that all patients with central venous catheter (CVC) need to be performed, and included nurses' checks for insertion practices and doctors' checks for maintenance practices. Propensity scores matching were used to account for potential confounding, and restricted cubic spline was served as visualizing the CABSI risk. RESULTS A total of 2906 patients with 26,157 CVC-days were analyzed. After intervention, the density incidence of CABSI decreased from 10.24 to 6.33/1,000 CVC-days (P < 0.001), and the acute period of rapid increase in CABSI risk was shortened, 6.5 to 5 days for femoral-vein catheterization and 7 to 5.5 days for subclavian-vein catheterization. For jugular-vein catheterization, the acute onset period disappeared. CONCLUSION Enhanced check during the first 7 calendar days after CVC insertion shortens the duration of the CABSI acute phase and tends to decrease CABSI rate.
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Affiliation(s)
- Yu Lv
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Xiaobo Huang
- grid.54549.390000 0004 0369 4060Intensive Care Unit, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Qian Xiang
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Qin Yang
- grid.54549.390000 0004 0369 4060Department of Nursing, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Jin Chen
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Minhong Cai
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Pingping Wang
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Ping Jia
- grid.54549.390000 0004 0369 4060Intensive Care Unit, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Hui Wang
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Caixia Xie
- grid.54549.390000 0004 0369 4060Department of Nursing, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Luting Li
- Development Department, Chengdu Yiou Technology Co. LTD, Chengdu, 610000 Sichuan People’s Republic of China
| | - Dingding Zhang
- grid.54549.390000 0004 0369 4060Sichuan Provincial Key Laboratory for Disease Gene Study, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Daoqiong Wei
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
| | - Jiayu Wu
- grid.54549.390000 0004 0369 4060Healthcare-Associated Infection Control Center, Sichuan Academy of Medical Sciences, Sichuan People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072 Sichuan People’s Republic of China
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13
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Chabrolles H, Pons-Rejraji H, Chaput L, Brebion A, Fiot M, Pereira B, Brugnon F, Henquell C. Validation of a SARS-CoV-2 RT-PCR assay: a requirement to evaluate viral contamination in human semen. Reprod Biomed Online 2022; 45:1247-1254. [PMID: 36270932 PMCID: PMC9444588 DOI: 10.1016/j.rbmo.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/18/2022] [Accepted: 09/01/2022] [Indexed: 01/12/2023]
Abstract
RESEARCH QUESTION Is it possible to validate an accurate and reliable method for direct detection of SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) in human semen fractions? DESIGN This qualitative improvement study aimed to provide a prospective validation of SARS-CoV-2 detection in male semen. The SARS-CoV-2 genome was detected by multiplex real-time RT-PCR on patient samples that underwent routine semen analyses for infertility at the Center for Reproductive Medicine at the University Hospital of Clermont-Ferrand. Samples comprised surplus semen collected for treatment with assisted reproductive technology. Seminal fluid and spermatozoa fractions were isolated with density gradient centrifugation and cryopreserved. Positive samples were prepared with a standard of inactivated SARS-CoV-2 particles. RESULTS The analytical method was validated in both seminal fluid and spermatozoa fractions. In both semen fractions, the assay was repeatable, reproducible and showed high sensitivity with a limit of detection of 0.33 SARS-CoV-2 genome copies/µl. The limit of quantification was 1 copy of the SARS-CoV-2 genome/µl. The method was effective regardless of semen quality (normal and altered sperm parameters), number of spermatozoa or the cryoprotectant media used to freeze spermatozoa. CONCLUSION This validated RT-PCR assay provided accurate and reliable screening of SARS-CoV-2 in seminal fluid and spermatozoa fractions. This method is essential to ensure protection against viral contamination in the cryobanking process.
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Affiliation(s)
- Hélène Chabrolles
- CHU Clermont-Ferrand, Laboratoire de Virologie, 3IHP, Clermont-Ferrand, France; Université Clermont Auvergne, UMR CNRS 6023-LMGE, Clermont-Ferrand, France
| | - Hanae Pons-Rejraji
- CHU Clermont-Ferrand, Service AMP-CECOS, Clermont-Ferrand, France; Université Clermont Auvergne, INSERM 1240, IMoST (Imagerie Moléculaire et Stratégies Théranostiques), Clermont-Ferrand, France.
| | - Laure Chaput
- CHU Clermont-Ferrand, Service AMP-CECOS, Clermont-Ferrand, France; Université Clermont Auvergne, INSERM 1240, IMoST (Imagerie Moléculaire et Stratégies Théranostiques), Clermont-Ferrand, France
| | - Amélie Brebion
- CHU Clermont-Ferrand, Laboratoire de Virologie, 3IHP, Clermont-Ferrand, France
| | - Mélanie Fiot
- CHU Clermont-Ferrand, Service AMP-CECOS, Clermont-Ferrand, France; Université Clermont Auvergne, INSERM 1240, IMoST (Imagerie Moléculaire et Stratégies Théranostiques), Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation Recherche Clinique and Innovation, Méthodologie, Biostatistique, Data Management, Clermont-Ferrand, France
| | - Florence Brugnon
- CHU Clermont-Ferrand, Service AMP-CECOS, Clermont-Ferrand, France; Université Clermont Auvergne, INSERM 1240, IMoST (Imagerie Moléculaire et Stratégies Théranostiques), Clermont-Ferrand, France
| | - Cécile Henquell
- CHU Clermont-Ferrand, Laboratoire de Virologie, 3IHP, Clermont-Ferrand, France; Université Clermont Auvergne, UMR CNRS 6023-LMGE, Clermont-Ferrand, France
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14
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Montano M, Victor AR, Griffin DK, Duong T, Bolduc N, Farmer A, Garg V, Hadjantonakis AK, Coates A, Barnes FL, Zouves CG, Greene WC, Viotti M. SARS-CoV-2 can infect human embryos. Sci Rep 2022; 12:15451. [PMID: 36104397 PMCID: PMC9472724 DOI: 10.1038/s41598-022-18906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
The spread of SARS-CoV-2 has led to a devastating pandemic, with infections resulting in a range of symptoms collectively known as COVID-19. The full repertoire of human tissues and organs susceptible to infection is an area of active investigation, and some studies have implicated the reproductive system. The effects of COVID-19 on human reproduction remain poorly understood, and particularly the impact on early embryogenesis and establishment of a pregnancy are not known. In this work, we explore the susceptibility of early human embryos to SARS-CoV-2 infection. By using RNA-seq and immunofluorescence, we note that ACE2 and TMPRSS2, two canonical cell entry factors for SARS-CoV-2, are co-expressed in cells of the trophectoderm in blastocyst-stage preimplantation embryos. For the purpose of viral entry studies, we used fluorescent reporter virions pseudotyped with Spike (S) glycoprotein from SARS-CoV-2, and we observe robust infection of trophectoderm cells. This permissiveness could be attenuated with blocking antibodies targeting S or ACE2. When exposing human blastocysts to the live, fully infectious SARS-CoV-2, we detected cases of infection that compromised embryo health. Therefore, we identify a new human target tissue for SARS-CoV-2 with potential medical implications for reproductive health during the COVID-19 pandemic and its aftermath.
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15
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Kabalkin Y, Bentov Y, Gil M, Beharier O, Jaber S, Moav-Zafrir A, Khwies D, Ben-Meir A, Esh Broder E, Walfisch A, Holzer HEG, Hershko Klement A. Mild COVID-19 Was Not Associated with Impaired IVF Outcomes or Early Pregnancy Loss in IVF Patients. J Clin Med 2022; 11:jcm11185265. [PMID: 36142911 PMCID: PMC9505769 DOI: 10.3390/jcm11185265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Data collection regarding the effects of COVID-19 on reproduction is ongoing. This study examined the effect of COVID-19 on IVF cycle parameters and early pregnancy outcomes. It included two arms: the first compared non-exposed cycles to post-SARS-CoV-2 IVF cycles. Sperm parameters were also compared. The second, prospective arm compared pregnancy outcomes among IVF patients who contracted COVID-19 during early pregnancy to those who did not. None of the patients were vaccinated against SARS-CoV-2. The first arm included 60 treatment cycles of women with confirmed COVID-19, compared to 60 non-exposed cycles (either the same patient before exposure or matched non-exposed patients). The outcomes of the treatment cycles did not differ significantly between exposed and non-exposed groups, including number of oocytes, endometrial thickness, fertilization rate and number of top-quality embryos. In 11 cycles, the male partner had also recently recovered: sperm concentration was lower post-exposure: 6.27 million/mL vs. 16.5 pre-exposure (p = 0.008). In 189 patients with IVF-achieved pregnancies, pregnancy loss and hospital admissions did not differ between exposed and non-exposed groups. IVF treatment outcomes and the rate of early pregnancy loss appears to be unaffected by SARS-CoV-2 disease, despite a minor decline in sperm concentration among recent recoverees.
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Affiliation(s)
- Yossef Kabalkin
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Yaakov Bentov
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
- Correspondence:
| | - Moran Gil
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Ein Kerem-Hebrew University Medical Center, Jerusalem 91220, Israel
| | - Ofer Beharier
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Sireen Jaber
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Arbel Moav-Zafrir
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Dua’ Khwies
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Assaf Ben-Meir
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Ein Kerem-Hebrew University Medical Center, Jerusalem 91220, Israel
| | - Efrat Esh Broder
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Asnat Walfisch
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Hananel E. G. Holzer
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Anat Hershko Klement
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
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Luddi A, Luongo FP, Dragoni F, Fiaschi L, Vicenti I, Lupetti P, Gentile M, Paccagnini E, Haxhiu A, Ponchia R, Governini L, Zazzi M, Piomboni P. Cellular and Molecular Mechanisms of In Vivo and In Vitro SARS-CoV-2 Infection: A Lesson from Human Sperm. Cells 2022; 11:cells11172631. [PMID: 36078041 PMCID: PMC9455059 DOI: 10.3390/cells11172631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Despite the major target of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, being the respiratory system, clinical evidence suggests that the male reproductive system may represent another viral target organ. Revealing the effect of SARS-CoV-2 infection on testis and sperm is a priority for reproductive biology, as well as for reproductive medicine. Here, we confirmed that the SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) is highly expressed on human testis and ejaculated sperm; moreover, we provide evidence for the expression of the co-receptors transmembrane protease/serine (TMPRSS2), Basigin (BSG), and Catepsin L (CTSL). Human sperm were readily infected, both in vivo and in vitro, by SARS-CoV-2, as demonstrated by confocal and electron microscopy. The demonstration that the seminiferous epithelium and sperm support SARS-CoV-2 viral replication suggests the possibility that the spermatogenetic process may be detrimentally affected by the virus, and at the same time, supports the need to implement safety measures and guidelines to ensure specific care in reproductive medicine.
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Affiliation(s)
- Alice Luddi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Francesca Paola Luongo
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lia Fiaschi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Pietro Lupetti
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | | | | | - Alesandro Haxhiu
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Rosetta Ponchia
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Laura Governini
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- Correspondence: (L.G.); (M.Z.); Tel.: +39-0577-586810 (L.G.); +39-0577-233863 (M.Z.)
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Correspondence: (L.G.); (M.Z.); Tel.: +39-0577-586810 (L.G.); +39-0577-233863 (M.Z.)
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
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Mintziori G, Duntas LH, Veneti S, Goulis DG. Metabolic, Oxidative and Psychological Stress as Mediators of the Effect of COVID-19 on Male Infertility: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095277. [PMID: 35564672 PMCID: PMC9099932 DOI: 10.3390/ijerph19095277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 12/18/2022]
Abstract
Over 300 million patients with coronavirus disease 2019 (COVID-19) have been reported worldwide since the outbreak of the pandemic in Wuhan, Hubei Province, China. COVID-19 is induced by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The effect of SARS-CoV-2 infection on the male reproductive system is unclear. The aim of this review is to assess the effect of SARS-CoV-2 infection on male fertility and the impact of possible mediators, such as metabolic, oxidative and psychological stress. SARS-CoV-2 infection aggravates metabolic stress and directly or indirectly affects male fertility by reducing seminal health. In addition, SARS-CoV-2 infection leads to excessive production of reactive oxygen species (ROS) and increased psychological distress. These data suggest that SARS-CoV-2 infection reduces male fertility, possibly by means of metabolic, oxidative and psychological stress. Therefore, among other consequences, the possibility of COVID-19-induced male infertility should not be neglected.
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Affiliation(s)
- Gesthimani Mintziori
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki Medical School, Papageorgiou Gneral Hospital, 56429 Thessaloniki, Greece; (S.V.); (D.G.G.)
- Correspondence:
| | - Leonidas H. Duntas
- Unit of Endocrinology, Diabetes and Metabolism, Thyroid Section, Evgenideion Hospital, University of Athens, 20 Papadiamantopoulou Str., 11528 Athens, Greece;
| | - Stavroula Veneti
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki Medical School, Papageorgiou Gneral Hospital, 56429 Thessaloniki, Greece; (S.V.); (D.G.G.)
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki Medical School, Papageorgiou Gneral Hospital, 56429 Thessaloniki, Greece; (S.V.); (D.G.G.)
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Delli Muti N, Finocchi F, Tossetta G, Salvio G, Cutini M, Marzioni D, Balercia G. Could SARS-CoV-2 infection affect male fertility and sexuality? APMIS 2022; 130:243-252. [PMID: 35114008 PMCID: PMC9314998 DOI: 10.1111/apm.13210] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/25/2022] [Indexed: 02/06/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is the cause of coronavirus infectious disease (COVID‐19) and has rapidly spread worldwide, causing serious problems to the healthcare systems of many countries and hundreds of thousand deaths. In this review we discuss data from the literature to understand whether the various districts of the male reproductive system may represent another vulnerable target for SARS‐CoV‐2. Studies were searched from electronic databases such as Google Scholar, PubMed, Scopus, and COVID‐19 specific databases such as LitCovid, until July 31, 2021. It appears that SARS‐CoV‐2 virus infection not only causes damage to the respiratory system, but could have a serious impact on the reproductive system of male patients modulating many physiological processes. Like some other infections, SARS‐CoV‐2 also leads to a worsening of semen quality and an increase in oxidative stress (OS) levels. However, due to the limited number of studies, it is unclear whether this deterioration in semen parameters is temporary or lasts over time. It is certainly important that patients' reproductive function is monitored after coronavirus infection to avoid problems in reproductive health in the future.
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Affiliation(s)
- Nicola Delli Muti
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Federica Finocchi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Giovanni Tossetta
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy.,Clinic of Obstetrics and Gynaecology, Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Gianmaria Salvio
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Melissa Cutini
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Daniela Marzioni
- Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Giancarlo Balercia
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
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