Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;
Rom J Morphol Embryol. 2022 Jul-Sep;63(3):503-510. doi: 10.47162/RJME.63.3.04.
The appearance of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a major obstacle for the performing of current medical activities throughout the world. COVID-19 has affected humanity in many ways, thus causing a great medical, social, economic, and political instability. The aim of this study was to make an analysis of the scientific data obtained by so far to highlight the impact that COVID-19 has had on fertility and assisted reproductive technology (ART). Infection with SARS-CoV-2 alters the normal immune response by local and systemic damage to tissues and organs. After the virus enters the body, the first lesions are produced in the respiratory tract. Extrapulmonary lesions specific to COVID-19 include acute renal lesions/acute kidney damage, hepatocellular lesions, neurological diseases, myocardial dysfunction and arrhythmia, gastrointestinal diseases but also genital impairment. The possible impairment of the male reproductive system is because angiotensin-converting enzyme 2 (ACE2) receptors are in an increased number in the testes, seminiferous duct cells, spermatogonia, Leydig cells and Sertoli cells. Many published studies to date have pointed out that COVID-19 could also affect female fertility and disrupt the functions of the female reproductive system. The theory that this virus can also be transmitted sexually and can cause infertility or testicular damage is supported by the fact that the virus can be isolated in the semen of COVID-19 patients but only during the disease. Choosing the best method of treating infertility during the COVID-19 pandemic is multifactorial, but the risk of infection and compliance with specific ART hygiene protocols must always be considered. Currently, there is no scientific basis regarding the fact that the COVID-19 vaccination would influence fertility.
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，这是全世界当前医疗活动的主要障碍。COVID-19 以多种方式影响人类，因此导致了巨大的医学、社会、经济和政治不稳定。本研究旨在对迄今为止获得的科学数据进行分析，以突出 COVID-19 对生育和辅助生殖技术（ART）的影响。SARS-CoV-2 的感染通过对组织和器官的局部和全身损伤改变正常的免疫反应。病毒进入人体后，首先在呼吸道产生病变。COVID-19 的肺外特定病变包括急性肾损伤/急性肾损伤、肝细胞损伤、神经系统疾病、心肌功能障碍和心律失常、胃肠道疾病以及生殖器损伤。男性生殖系统可能受损，因为血管紧张素转换酶 2（ACE2）受体在睾丸、生精小管细胞、精原细胞、莱迪希细胞和支持细胞中数量增加。迄今为止发表的许多研究指出，COVID-19 也可能影响女性生育能力并破坏女性生殖系统的功能。该病毒也可以通过性传播并导致不孕或睾丸损伤的理论得到了支持，因为可以在 COVID-19 患者的精液中分离出该病毒，但仅在发病期间。在 COVID-19 大流行期间选择治疗不孕的最佳方法是多因素的，但必须始终考虑感染风险和遵守特定的 ART 卫生协议。目前，关于 COVID-19 疫苗会影响生育能力的事实尚无科学依据。
