ISSN : 2146-3123
E-ISSN : 2146-3131

Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative Review
Soheila Pourmasumi1,2, Nicholas G. Kounis3, Monavar Naderi4, Robabe Hosseinisadat5, Arezoo Khoradmehr6, Niloofar Fagheirelahee7, Sophia N. Kouni8, Cesare de Gregorio9, Periklis Dousdampanis10, Virginia Mplani11, Marina A. Michalaki12, Panagiotis Plotas13, Stelios Assimakopoulos14, Christos Gogos15, Georgios Aidonidis16, Pavlos Roditis17, Nikos Matsas18, Dimitrios Velissaris19, Gianfranco Calogiuri20,21, Ming-Yow Hung22,23,24, Ioanna Koniari25
1Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
2Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
3Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, Patras, Greece
4Knowledge and Information Science, Vice Chancellor for Science and Technology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
5Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
6The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
7Department of Anatomy, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
8Speech Therapy Practice, Queen Olgas Square, Patras, Greece
9Department of Clinical and Experimental Medicine, University of Messina Medical School, Messina, Italy
10Department of Nephrology, Saint Andrews State General Hospital, Patras, Greece
11Intensive Care Unit, Patras University Hospital, Patras, Greece
12Department of Internal Medicine, Division of Endocrinology, Fculty of Health Sciences, University of Patras, Patras, Greece
13Department of Speech Therapy, University of Patras, Patras, Greece
14Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Patras, Greece
15COVID-19 Unit, Papageorgiou General Hospital, Thessaloniki, Greece
16Interbalkan Medical Center, Thessaloniki, Greece
17Department of Cardiology, Mamatsio Kozanis General Hospital, Kozani, Greece
18Cardiology Private Practice, Agrinion, Greece
19Department of Internal Medicine, University of Patras, Patras, Greece
20Pneumonology Department, Civil Hospital “Ninetto Melli”, Pietro Vernoti, Brindisi, Italy
21Department of Internal Medicine, Immunology and Infectious Diseases, Section of Allergology and Clinical Immunology, University of Bari Medical School, Bari, Italy
22Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
23Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
24Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
25Departmentof Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
DOI : 10.4274/balkanmedj.galenos.2023.2023-3-4
Pages : 153-164

Abstract

Several studies and research papers have been published to elucidate and understand the mechanism of the coronavirus disease 2019 (COVID-19) pandemic and its long-term effects on the human body. COVID-19 affects a number of organs, including the female reproductive system. However, less attention has been given to the effects of COVID-19 on the female reproductive system due to their low morbidity. The results of studies investigating the relationship between COVID-19 infection and ovarian function in women of reproductive age have shown the harmless involvement of COVID-19 infection. Several studies have reported the involvement of COVID-19 infection in oocyte quality, ovarian function, and dysfunctions in the uterine endometrium and the menstrual cycle. The findings of these studies indicate that COVID-19 infection negatively affects the follicular microenvironment and dysregulate ovarian function. Although the COVID-19 pandemic and female reproductive health have been studied in humans and animals, very few studies have examined how COVID-19 affects the female reproductive system. The objective of this review is to summarize the current literature and categorize the effects of COVID-19 on the female reproductive system, including the ovaries, uterus, and hormonal profiles. The effects on oocyte maturation, oxidative stress, which causes chromosomal instability and apoptosis in ovaries, in vitro fertilization cycle, high-quality embryos, premature ovarian insufficiency, ovarian vein thrombosis, hypercoagulable state, women’s menstrual cycle, the hypothalamus-pituitary-ovary axis, and sex hormones, including estrogen, progesterone, and the anti-Müllerian hormone, are discussed in particular.

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