Abstract
Fertility preservation has always been an important part of reproductive medicine. It has acquired a new dimension in the current period of the Coronavirus crisis. The effects of COVID-19 on affected people’s reproductive function in the medium and long term cannot be predicted with certainty. Fertility may also be affected by some treatment agents used against COVID-19. Fertility preservation in vivo, suitable in young persons with no apparent fertility problems, can be made with the use of nontoxic and generally fertility-friendly agents, such as melatonin and vitamin D. For older persons and those with already present fertility problems, in vitro fertility preservation, using gamete or embryo freezing, appears preferable. Finally, the same nontoxic agents recommended for in vivo fertility preservation should be given systematically to all pregnant women to protect them against infection during this critical period of life.
Highlights
Fertility preservation has been a significant concern of clinicians and scientists working in infertility diagnosis and treatment for several decades
The same nontoxic agents recommended for in vivo fertility preservation should be given systematically to all pregnant women to protect them against infection during this critical period of life
Both Leydig cells, responsible for steroidogenesis, and Sertoli cells, responsible for the protection and nutrition of spermatogenic cells throughout their development, can be infected. The infection of these types of ovarian and testicular cells can affect negatively the development of gametes. This is the testis case, where hormonal alterations in patients with COVID-19 could lead to the formation of antisperm antibodies and subsequent immunological infertility, an increase in the sperm DNA fragmentation, and inflammation leading to spermatogenesis failure [2, 3]
Summary
Fertility preservation has been a significant concern of clinicians and scientists working in infertility diagnosis and treatment for several decades. Even before the outbreak of COVID-19, more than a half of persons (76% of women and 61% of men) seeking infertility treatment showed anxiety symptomatology [6], and these figures are likely to further increase because of Journal of Fertility Preservation the uncertainty of whether and how COVID-19 will impair the fertility status of these people This Opinion article focuses on measures that can be taken for the protection of gametes from in vivo damage, applicable to young persons who are still healthy, cryostorage of gametes and embryos for already infected persons in the asymptomatic phase or those showing mild symptoms of the disease, avoidance of the use of therapeutic agents with known or suspected gametotoxic effects for persons in reproductive age, and the protection of pregnant women against the potential impacts of COVID-19 on pregnancy outcome
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