Abstract
AbstractCoronavirus disease 2019 (COVID-19) is a serious respiratory disease mediated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The worldwide spread of COVID-19 has caused millions of confirmed cases and morbidity, and the crisis has greatly affected global economy and daily life and changed our attitudes towards life. The reproductive system, as a potential target, is at a high risk of SARS-CoV-2 infection, and females are more vulnerable to viral infection compared with males. Therefore, female fertility and associated reproductive health care in the COVID-19 era need more attention. This review summarises the mechanism of SARS-CoV-2 infection in the female reproductive system and discusses the impact of the COVID-19 crisis on female fertility. Studies have proven that COVID-19 might affect female fertility and interfere with assisted reproductive technology procedures. The side effects of vaccines against the virus on ovarian reserve and pregnancy have not yet been well investigated. In the future, the female fertility after SARS-CoV-2 infection and vaccination needs more attention because of the uncertainty of COVID-19.
Highlights
Coronavirus disease 2019 (COVID-19) is a serious respiratory disease mediated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (Ref. 1)
Females are more vulnerable to viral infection compared with males (Ref. 8), putting females – in particular, females of childbearing age – at an increased risk of reproductive system impairment
We summarise the mechanism of SARS-CoV-2 infection in the female reproductive system, review the impacts of the COVID-19 crisis on female fertility and discuss the current status of reproductive health care during the pandemic
Summary
Coronavirus disease 2019 (COVID-19) is a serious respiratory disease mediated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (Ref. 1). We summarise the mechanism of SARS-CoV-2 infection in the female reproductive system, review the impacts of the COVID-19 crisis on female fertility and discuss the current status of reproductive health care during the pandemic. SARS-CoV-2 infection has been proven to decrease the activity and downregulate the expression of ACE2, resulting in an increase of Ang II recruitment and a decrease in Ang-(1–7) production in circulation, which explains the inflammatory reactions investigated in COVID-19 patients (Refs 30, 31).
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