Department of Physiology, Jining Medical University, Jining, China.
Hum Reprod. 2021 Dec 27;37(1):5-13. doi: 10.1093/humrep/deab238.
The coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has precipitated a global health crisis of unprecedented proportions. Because of its severe impact, multiple COVID-19 vaccines are being rapidly developed, approved and manufactured. Among them, mRNA vaccines are considered as ideal candidates with special advantages to meet this challenge. However, some serious adverse events have been reported after their application, significantly increasing concerns about the safety and efficacy of the vaccines and doubts about the necessity of vaccination. Although several fertility societies have announced that COVID-19 mRNA vaccines are unlikely to affect fertility, there is no denying that the current evidence is very limited, which is one of the reasons for vaccine hesitancy in the population, especially in pregnant women. Herein, we provide an in-depth discussion on the involvement of the male and female reproductive systems during SARS-CoV-2 infection or after vaccination. On one hand, despite the low risk of infection in the male reproductive system or fetus, COVID-19 could pose an enormous threat to human reproductive health. On the other hand, our review indicates that both men and women, especially pregnant women, have no fertility problems or increased adverse pregnancy outcomes after vaccination, and, in particular, the benefits of maternal antibodies transferred through the placenta outweigh any known or potential risks. Thus, in the case of the rapid spread of COVID-19, although further research is still required, especially a larger population-based longitudinal study, it is obviously a wise option to be vaccinated instead of suffering from serious adverse symptoms of virus infection.
新型冠状病毒病 2019（COVID-19）由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起，引发了一场前所未有的全球卫生危机。由于其严重影响，多种 COVID-19 疫苗正在迅速开发、批准和生产。其中，mRNA 疫苗被认为是应对这一挑战的理想候选疫苗，具有特殊优势。然而，在应用后报告了一些严重的不良事件，这显著增加了人们对疫苗安全性和有效性的担忧，并对疫苗接种的必要性产生了怀疑。尽管有几个生育协会宣布 COVID-19 mRNA 疫苗不太可能影响生育能力，但不可否认的是，目前的证据非常有限，这也是导致人们对接种犹豫不决的原因之一，尤其是孕妇。在此，我们深入讨论了 SARS-CoV-2 感染或接种疫苗后男性和女性生殖系统的参与情况。一方面，尽管 COVID-19 在男性生殖系统或胎儿中感染的风险较低，但它仍可能对人类生殖健康构成巨大威胁。另一方面，我们的综述表明，男性和女性，尤其是孕妇，在接种疫苗后没有生育问题或增加不良妊娠结局，特别是通过胎盘转移的母体抗体的益处大于任何已知或潜在的风险。因此，在 COVID-19 迅速传播的情况下，尽管仍需要进一步研究，特别是更大的基于人群的纵向研究，但接种疫苗而不是遭受病毒感染的严重不良症状显然是明智的选择。
