The Effects of COVID-19 from Fertilization until Birth: A Literature Review

Background: Due to the presence of the main receptor of SARS-CoV-2 (ACE2) in the male and female reproductive systems, infertility and viral damage during pregnancy are possible, in addition to premature birth, abnormal birth, and even maternal death. Objectives: This study aimed to review the effects of COVID-19 from fertilization until birth. Methods: By searching relevant keywords, a total of 205 articles were retrieved, 62 of which were finally reviewed in this study. Also, the Fertility Society of Australia (FSA), European Society of Human Reproduction and Embryology (ESHRE), and Human Fertilisation and Embryology Authority (HFEA) websites were checked to find reports on infertility management during the COVID-19 pandemic in other countries. Results:: The coronavirus receptor (ACE2) is expressed in the tissues of the male and female reproductive systems, as well as various embryonic stages. The fetus is most likely to be infected by the virus at the time of birth. However, there are few reports of vertical transmission from the mother to the fetus before birth. Couples are generally suggested to freeze their embryos after the COVID-19 pandemic is eradicated. Conclusion: Considering the presence of the new coronavirus receptors in the male and female reproductive systems, besides reports on the destructive effects of this virus on different parts of the male and female reproductive systems, COVID-19 can harm the next generation, as well as the current world population. Therefore, couples are advised to avoid pregnancy during the COVID-19 outbreak. In the case of pregnancy, they are asked to observe the health protocols as much as possible to prevent the spread of disease.  

Keywords:

COVID-19 , reproductive system , pregnancy , fertilization , vertical transmission , embryo , infertility treatment , birth