Dolgushina Nataliya V, Menzhinskaya Irina V, Ermakova Daria M, Frankevich Natalia A, Vtorushina Valentina V, Sukhikh Gennady T
National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of Ministry of Healthcare of the Russian Federation, 117997 Moscow, Russia.
Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Federal State Autonomous Educational Institution of Higher Education the First Moscow State Medical University Named after I.M. Sechenov of Ministry of Health of the Russian Federation (Sechenov University), 119048 Moscow, Russia.
J Clin Med. 2023 Jun 29;12(13):4370. doi: 10.3390/jcm12134370.
It is assumed that SARS-CoV-2- and COVID-19-associated autoimmune processes may affect the outcomes of assisted reproductive technology (ART) cycles. This observational prospective study included 240 infertile patients: 105 patients had no history of COVID-19 (group 1) and 135 patients had experienced COVID-19 (group 2) in a mild (n = 85) or moderate (n = 50) form less than 12 months prior to oocyte retrieval. Using ELISAs, the profiles of their serum autoantibodies were determined, including antiphospholipid antibodies and antibodies to nuclear and thyroid antigens. The parameters of oogenesis and embryogenesis, as well as the pregnancy and childbirth rates, did not differ between groups 1 and 2, and also between the subgroups with different severities of COVID-19. However, when oocyte retrieval was performed less than 180 days after COVID-19, a higher proportion of poor-quality blastocysts was obtained ( = 0.006). A high risk of early miscarriage was found in the patients with moderate COVID-19. In group 2, IgG antibodies to annexin V, phosphatidylethanolamine (PE), and TSHr were detected more often than in group 1 ( = 0.035; = 0.028; and = 0.033, respectively), and a weak inverse correlation was revealed between anti-PE IgG and the number of oocytes and zygotes obtained. The results of the study suggest a possible adverse effect of COVID-19 and its associated autoantibodies on the outcomes of fresh oocyte ART cycles and early pregnancy, which depends on the severity of COVID-19 and the time interval after the disease.
据推测，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）和2019冠状病毒病（COVID-19）相关的自身免疫过程可能会影响辅助生殖技术（ART）周期的结局。这项前瞻性观察研究纳入了240例不孕患者：105例患者无COVID-19病史（第1组），135例患者在取卵前不到12个月曾经历过轻度（n = 85）或中度（n = 50）形式的COVID-19（第2组）。使用酶联免疫吸附测定（ELISA）法测定其血清自身抗体谱，包括抗磷脂抗体以及抗核和抗甲状腺抗原的抗体。第1组和第2组之间，以及COVID-19不同严重程度的亚组之间，卵子发生和胚胎发生参数以及妊娠和分娩率均无差异。然而，在COVID-19后不到180天进行取卵时，获得的低质量囊胚比例更高（P = 0.006）。发现中度COVID-19患者早期流产风险高。在第2组中，膜联蛋白V、磷脂酰乙醇胺（PE）和促甲状腺激素受体（TSHr）的IgG抗体检测频率高于第1组（分别为P = 0.035、P = 0.028和P = 0.033），并且抗PE IgG与获得的卵母细胞和受精卵数量之间呈弱负相关。研究结果表明，COVID-19及其相关自身抗体可能对新鲜卵母细胞ART周期结局和早期妊娠产生不利影响，这取决于COVID-19的严重程度和疾病后的时间间隔。
