Division of Reproductive Sciences, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
Fertil Steril. 2020 Jun;113(6):1140-1149. doi: 10.1016/j.fertnstert.2020.04.025. Epub 2020 Apr 16.
To summarize current understanding of the effects of novel and prior coronaviruses on human reproduction, specifically male and female gametes, and in pregnancy.
Review of English publications in PubMed and Embase to April 6, 2020.
METHOD(S): Articles were screened for reports including coronavirus, reproduction, pathophysiology, and pregnancy.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Reproductive outcomes, effects on gametes, pregnancy outcomes, and neonatal complications.
RESULT(S): Seventy-nine reports formed the basis of the review. Coronavirus binding to cells involves the S1 domain of the spike protein to receptors present in reproductive tissues, including angiotensin-converting enzyme-2 (ACE2), CD26, Ezrin, and cyclophilins. Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) may cause severe orchitis leading to germ cell destruction in males. Reports indicate decreased sperm concentration and motility for 72-90 days following Coronavirus Disease 2019 (COVID-19) infection. Gonadotropin-dependent expression of ACE2 was found in human ovaries, but it is unclear whether SARS-Coronavirus 2 (CoV-2) adversely affects female gametogenesis. Evidence suggests that COVID-19 infection has a lower maternal case fatality rate than SARS or Middle East respiratory syndrome (MERS), but anecdotal reports suggest that infected, asymptomatic women may develop respiratory symptoms postpartum. Coronavirus Disease 2019 infections in pregnancy are associated with preterm delivery. Postpartum neonatal transmission from mother to child has been reported.
CONCLUSION(S): Coronavirus Disease 2019 infection may affect adversely some pregnant women and their offspring. Additional studies are needed to assess effects of SARS-CoV-2 infection on male and female fertility.
总结新型和先前冠状病毒对人类生殖，特别是男性和女性配子以及妊娠的影响的现有认识。
对 2020 年 4 月 6 日前在 PubMed 和 Embase 上发表的英文出版物进行回顾。
筛选出包括冠状病毒、生殖、病理生理学和妊娠的报告。
无。
生殖结局、对配子的影响、妊娠结局和新生儿并发症。
79 篇报告构成了综述的基础。冠状病毒与细胞的结合涉及刺突蛋白的 S1 结构域与生殖组织中存在的受体结合，包括血管紧张素转换酶 2（ACE2）、CD26、Ezrin 和亲环蛋白。严重急性呼吸综合征冠状病毒 1（SARS-CoV-1）可能导致严重的睾丸炎，导致男性生殖细胞破坏。有报道称，感染 2019 冠状病毒病（COVID-19）后，精子浓度和活力下降 72-90 天。在人类卵巢中发现了依赖促性腺激素的 ACE2 表达，但尚不清楚 SARS-冠状病毒 2（CoV-2）是否会对女性配子发生产生不利影响。有证据表明，COVID-19 感染的孕产妇病死率低于 SARS 或中东呼吸综合征（MERS），但传闻报告表明，感染的无症状女性产后可能出现呼吸道症状。妊娠期 COVID-19 感染与早产有关。有报道称，产妇向新生儿传播。
COVID-19 感染可能对一些孕妇及其后代产生不利影响。需要进一步研究评估 SARS-CoV-2 感染对男性和女性生育能力的影响。
