Fertility and Covid-19: What do we know?

As the world continues to suffer from the effects of the Covid-19 pandemic, a fresh golf apparently began to strike. The latest victim is Shanghai, a mega-city of more than 26 million. The measures announced there have put this nerve center of global finance in a virtual standstill.

The economic and associated health-related adverse effects of the pandemic have been well studied, but what the focus has missed is a deeper discussion of its impact on fertility. As more literature appears to emerge, it becomes clearer that we need to further investigate the effect of the pandemic on human fertility.

Covid-19 and human reproduction

Since the initial research on the impact of Covid-19 on fertility appeared, a number of outcomes appear to be at risk. The UNFPA report released in July 2021 reports that in 15 countries of the European Union the year-on-year birth rate dropped by 3.0% in October, 5.0% in November and 8.1% in December 2020, while in the United States fell by 7.7%. . The same report also concluded that Bangladesh stands out with an increase in births, but the number of births has generally decreased as mentioned above, also in Spain, Russia and France

But what this particular report seems to be missing is the risk of the adverse effects of Covid-19 directly on the reproductive and sexual health systems of Covid-19-positive individuals. In addition to assessing the impact of Covid-19 on physical outcomes, it is equally important to examine the psychosocial or social impact of the pandemic.

Although Covid-19 is primarily a respiratory infection, it can also infect the male reproductive system and several mechanisms have been suggested, including the impact on testicular architecture and spermatogenesis. Few case-controlled studies suggest that there may be a statistically significant change in sperm concentration and motility. Not just men, can affect Covid-19 female fertility and also disrupts female reproductive functions. World Economic Forum citing global studies on the impact of Covid-19 has suggested a link with significant increases in stillbirth, maternal mortality and maternal depression during the pandemic.

The impact of Covid-19 on future fertility is now a definite cause for concern among fertility experts and mental health practitioners.

Indian studies on the impact of Covid-19 on fertility and pregnancy

It is said that almost 50% of infertility is generally associated with malignancies or with a contribution of male factors. The causes for this include genetics, infections / STDs, previous surgeries and lifestyle choices. The above conditions can manifest in the form of a lack of sperm production or blockage of sperm transport within the body.

To understand the impact of Covid-19 on male infertility, IIT Bombay and Jaslok Hospital, Mumbai undertook an interesting study. They analyzed the seminal fluid of Covid-19-infected men for proteins known to be essential for spermatogenesis as well as for the process of fertilization between sperm and the ovum. Covid19. The study was conducted on men recovering from Covid-19 and was an attempt to gain insight into the long-term impact of Covid-19 infection on male reproduction. The study found an abnormality in expression of 48 proteins relevant for reproduction in men recovering from Covid-19 infection. The proteomic analysis suggested that there may be an association between Covid-19 and decrease in male fertility shortly after the Covid-19 infection. It is therefore suspected that men who have had Covid-19 may have reduced ability to have their own child shortly after Covid-19 infection, but it is not clear whether this impact will last long.

Research on the impact of Covid-19 on pregnancy and newborns

While reviewing the published literature, Dr Baris Ata, a senior consultant at ART Fertility Clinics, Dubai, who is on ESHRE (European Society of Human Reproduction and Embryology) working group on Covid-19 and co-author of five ESHRE publications about Covid was. -19 infection during pregnancies or during ART treatments, said: “Studies have concluded that the outcomes of ART pregnancies do not differ from spontaneous conceptions after Covid-19 infection. Furthermore, these studies suggest that newborns protect are by antibodies of mothers who had Covid-19 during pregnancy, however, there is also evidence that severe Covid-19 disease during pregnancy may increase the risk of damaging the placenta and consequently the risk of smaller and at-risk infants or premature infants. can increase. ”

Road ahead

Of the various medical consequences of Covid-19 infection, its impact on fertility in general and in men in particular, may benefit from further study. Among fertility experts, there is consensus that a Covid-19 history should be an integral part of initiating any fertility treatment. Current research leads us to some very interesting findings, most of which may soon become visible to the outside world. Among the other important effects of Covid-19 is the detrimental impact on mental / psychosocial health.

However, it is important to note that in clinics with experienced and skilled staff, most male infertility can now be treated. It may require a visit to the clinic to identify the cause and then begin treatment. Clinics or hospitals that undertake their own research and focus on discovering the underlying reasons that cause infertility will be able to quickly identify the problem and create a customized treatment plan that is likely to work. Clinics offering ART should equip their clinicians and treatment teams with the latest scientific information. Experienced doctors who practice evidence-based medicine can then ensure that the journey is safe and the couples have the satisfaction of a healthy child of their own.

END OF ARTICLE