Balkan Medical Journal (May 2023)

Effects of COVID-19 Infection and Vaccination on the Female Reproductive System: A Narrative Review

  • Soheila Pourmasumi,
  • Nicholas G. Kounis,
  • Monavar Naderi,
  • Robabe Hosseinisadat,
  • Arezoo Khoradmehr,
  • Niloofar Fagheirelahee,
  • Sophia N. Kouni,
  • Cesare de Gregorio,
  • Periklis Dousdampanis,
  • Virginia Mplani,
  • Marina A. Michalaki,
  • Panagiotis Plotas,
  • Stelios Assimakopoulos,
  • Christos Gogos,
  • Georgios Aidonidis,
  • Pavlos Roditis,
  • Nikos Matsas,
  • DimitriosVelissaris,
  • Gianfranco Calogiuri,
  • Ming-Yow Hung,
  • Ioanna Koniari

DOI
https://doi.org/10.4274/balkanmedj.galenos.2023.2023-3-4
Journal volume & issue
Vol. 40, no. 3
pp. 153 – 164

Abstract

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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.