F&S reviews最新文献

{"title":"Gonadotropin-releasing hormone agonist (alone or combined with human chorionic gonadotropin) vs. human chorionic gonadotropin alone for ovulation triggering during controlled ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis","authors":"Mathilde Bourdon M.D., Ph.D. ,&nbsp;Maëliss Peigné M.D. ,&nbsp;Céline Solignac Pharm.D. ,&nbsp;Bernadette Darné M.D. ,&nbsp;Solène Languille Ph.D. ,&nbsp;Khaled Pocate-Cheriet M.D., Ph.D. ,&nbsp;Pietro Santulli M.D., Ph.D.","doi":"10.1016/j.xfnr.2021.08.003","DOIUrl":"10.1016/j.xfnr.2021.08.003","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate whether gonadotropin-releasing hormone agonist (GnRHa) triggering improves oocyte maturation<span>, pregnancy outcomes, and safety compared with human chorionic gonadotropin (hCG) triggering during controlled ovarian stimulation.</span></p></div><div><h3>Evidence Review</h3><p><span>A systematic review was performed using the following keywords: “GnRH agonist”; “hCG”; and “triggering.” Searches were conducted on MEDLINE, Embase, the Cochrane Library, </span><span>ClinicalTrials.gov</span><svg><path></path></svg><span><span>, and EudraCT for randomized controlled clinical trials between January 1, 1990, and April 15, 2020. The primary outcomes were the total number of retrieved oocytes and the number of mature oocytes. The main secondary outcomes were the number of embryos obtained, clinical pregnancy rate (CPR), </span>early pregnancy<span> loss rate, live birth rate, and incidence of ovarian hyperstimulation syndrome (OHSS). Two independent reviewers performed the study selection, bias assessment using the RoB2 tool, and data extraction according to the Cochrane methods. Random-effects meta-analysis was performed followed by prespecified sensitivity and subgroup analyses.</span></span></p></div><div><h3>Result(s)</h3><p>Our search yielded 1,369 published studies and 216 unpublished studies. After screening the titles and abstracts, 65 published studies and 25 unpublished abstracts were assessed for eligibility. Of these, we excluded 61 studies. A total of 29 randomized controlled trials were included. The 26 studies with the number of oocytes retrieved enrolled a total of 2,755 women, of whom 1,419 had GnRHa triggering and 1,336 had hCG alone for triggering. A total of 12 studies reported the number of mature oocytes with a total of 1,619 women (806 had GnRHa triggering and 813 had hCG alone for triggering). The mean numbers of retrieved oocytes (difference in the means [95% confidence interval], 0.99 [0.21, 1.78]; n = 26) and mature oocytes (0.68 [0.04, 1.33]; n = 12) were statistically significantly higher after GnRHa than after hCG triggering. A similar difference was observed for the number of embryos (0.94 [0.19, 1.68]; n = 10). No differences in the CPR (risk ratio, 1.01 [0.90, 1.14]; n = 23), early pregnancy loss (1.27 [0.94, 1.71]; n = 16), and live birth rate (1.00 [0.77, 1.29]; n = 6) were noted. Gonadotropin-releasing hormone agonist was associated with a lower incidence of OHSS (odds ratio, 0.25 [0.08, 0.74]; n = 20). Moreover, after dual triggering (GnRHa associated with hCG) compared with hCG alone, the meta-analysis showed a statistically significantly higher number of retrieved and mature oocytes and CPR.</p></div><div><h3>Conclusion(s)</h3><p>The final triggering using GnRHa allows a higher number of retrieved and mature oocytes to be obtained with comparable clinical outcomes and, after GnRHa alone, a lower OHSS risk compared with hCG triggering.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 4","pages":"Pages 353-370"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49054656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted reproductive technology outcomes in obese and diabetic men: lighting the darkness","authors":"Lis C. Puga Molina Ph.D. ,&nbsp;Pedro F. Oliveira Ph.D. ,&nbsp;Marco G. Alves Ph.D. ,&nbsp;David Martin-Hidalgo Ph.D.","doi":"10.1016/j.xfnr.2021.09.002","DOIUrl":"10.1016/j.xfnr.2021.09.002","url":null,"abstract":"<div><p><span>The prevalence of obesity and diabetes, two of the most prevalent metabolic disorders<span> (MetDs) in the world, has been rising exponentially over the last two decades. In addition to other comorbidities, MetDs have a detrimental impact on reproductive features, leading to a boost of the use of assisted reproductive technologies (ARTs) to overcome fertility problems. Although ARTs help to improve MetD male reproductive outcomes, data show that the results are less successful compared with those of men without MetD. Currently, </span></span>intracytoplasmic sperm injection<span><span> is the election procedure to bypass infertility in men with MetD. Nevertheless, embryos obtained by intracytoplasmic sperm injection using spermatozoa<span> of men with MetD have a lower probability to end in a live birth. This embryo development shutdown has been related to a higher rate of spermatozoa with fragmented DNA and with modifications on pathways that do not allow embryos to go further in the development process. This special detrimental feature of sperm from men with MetD indicates that advanced sperm selection techniques should be used in these patients to avoid sperm with fragmented DNA. Fortunately, sperm selection procedures are under constant development and eventually will allow physicians to select spermatozoa with higher quality and low </span></span>DNA fragmentation to be used in further ART, increasing the outcome of those procedures. Future research should be performed to enlighten alterations in embryos derived from spermatozoa of men with MetD.</span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 4","pages":"Pages 317-329"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47508398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Intracytoplasmic sperm injection (ICSI) improve live birth rate when compared to conventional in vitro fertilisation (IVF) in non-male factor infertility? A systematic review and meta-analysis","authors":"Astrid de Bantel-Finet, E. Arbo, M. Colombani, B. Darné, V. Gallot, V. Grzegorczyk-Martin, S. Languille, T. Fréour","doi":"10.1016/j.xfnr.2021.09.004","DOIUrl":"https://doi.org/10.1016/j.xfnr.2021.09.004","url":null,"abstract":"","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43086808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rooted in pre-assisted reproductive technology times menotropins are still used today: a narrative review of literature","authors":"Paul Pirtea M.D. ,&nbsp;Claus Yding Andersen Ph.D. ,&nbsp;Dominique de Ziegler M.D. ,&nbsp;Jean Marc Ayoubi M.D., Ph.D.","doi":"10.1016/j.xfnr.2021.04.002","DOIUrl":"10.1016/j.xfnr.2021.04.002","url":null,"abstract":"<div><p><span><span><span>Human menopausal gonadotropins (hMGs) had been developed long before the advent of </span>assisted reproductive technology (ART) for the induction of </span>ovulation<span> in women suffering from hypogonadotropic hypogonadism. The advent of ART offered a new application for hMGs, for inducing multiple follicular ovarian stimulation (OS) in generally normally ovulating women. The advent of follicle-stimulating hormone (FSH) preparations obtained by </span></span>genetic recombination<span> techniques in the early 1990s, recombinant FSH<span>, was originally seen as an imminent death knell for hMG preparations obtained from menopausal urine. Yet, 25 years later, hMG preparations—now in a highly purified form—are still part of our treatment options for OS in ART.</span></span></p><p>Over the years, meta-analyses have generally shown a similar or slight advantage in terms of ART outcomes (implantation, ongoing pregnancy, and live birth rates) for hMG preparations, albeit small in magnitude. Yet, recently, mounting evidence has indicated that certain women whose endogenous luteinizing hormone<span> (LH) levels are low, who are older, and/or who are prone to hyper-respond to OS are likely to benefit from receiving hMGs for OS. Today, hMG preparations gain their LH bioactivity from human chorionic gonadotropin obtained from a pituitary or chorionic source, with higher numbers of matured metaphase-II oocytes obtained in the latter case.</span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 239-250"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43186089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paternal smoking is associated with an increased risk of pregnancy loss in a dose-dependent manner: a systematic review and meta-analysis","authors":"Nadia A. du Fossé M.D. ,&nbsp;Marie-Louise P. van der Hoorn M.D., Ph.D. ,&nbsp;Nina H. Buisman B.Sc. ,&nbsp;Jan M.M. van Lith M.D., Ph.D. ,&nbsp;Saskia le Cessie Ph.D. ,&nbsp;Eileen E.L. O. Lashley M.D., Ph.D.","doi":"10.1016/j.xfnr.2021.06.001","DOIUrl":"10.1016/j.xfnr.2021.06.001","url":null,"abstract":"<div><h3>Objective</h3><p>To study the association between paternal lifestyle factors in the preconception period and the risk of pregnancy loss.</p></div><div><h3>Evidence Review</h3><p>The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines for systematic reviews and meta-analysis were followed. PubMed and Embase databases were searched up to August 2020. Original articles in English language addressing the relation between paternal exposure status in the preconception period and pregnancy loss were included. The paternal lifestyle factors examined were smoking, alcohol consumption, and body mass index. Studies that only examined exposure status during pregnancy (and not in the preconception period) and those that solely focused on pregnancy outcome after artificial reproductive technology were excluded. The qualitative risk of bias assessments was performed. Meta-analysis using a random-effects model was performed if sufficient data were available, with the risk of pregnancy loss as the primary outcome.</p></div><div><h3>Results</h3><p>The systematic search included 3,386 articles, of which 11 met the inclusion criteria. In a meta-analysis of 8 studies, paternal smoking of &gt;10 cigarettes per day in the preconception period was found to be associated with an increased risk of pregnancy loss, after adjustment for maternal smoking status (1–10 cigarettes per day, 1.01; 95% confidence interval [CI], 0.97–1.06; 11–19 cigarettes per day, 1.12; 95% CI, 1.08–1.16; ≥20 cigarettes per day, 1.23; 95% CI, 1.17–1.29). No clear association was found between paternal alcohol consumption and pregnancy loss, based on 5 available studies. No studies were identified evaluating the association between paternal body mass index and spontaneous pregnancy loss.</p></div><div><h3>Conclusion</h3><p>Awareness of the association between paternal smoking in the preconception period and the risk of pregnancy loss should be raised. More well-designed studies are needed to further investigate the effects of other paternal lifestyle factors on the risk of pregnancy loss.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 227-238"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47735416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emerging role of the gut microbiome in polycystic ovary syndrome","authors":"Yufeng He M.D. ,&nbsp;Xing Jin Ph.D. ,&nbsp;Haojue Wang M.D. ,&nbsp;Hongyan Dai B.D. ,&nbsp;Xianyi Lu B.D. ,&nbsp;Jianxin Zhao Ph.D. ,&nbsp;Hao Zhang M.D. ,&nbsp;Wei Chen Ph.D. ,&nbsp;Gang Wang Ph.D.","doi":"10.1016/j.xfnr.2021.03.003","DOIUrl":"10.1016/j.xfnr.2021.03.003","url":null,"abstract":"<div><p><span>Polycystic ovary syndrome<span><span> (PCOS) is a widespread endocrine disorder that affects women of reproductive age. Recent studies have demonstrated a close association between the </span>gut microbiome<span> and PCOS. Their microbial diversity may not significantly change, and the crucial role of </span></span></span><span><em>Bacteroides</em></span><span><span> spp. has been demonstrated in human PCOS. Furthermore, animal models of PCOS exhibit gut microbiome features different from those of humans with PCOS. The gut microbiome may differ in patients<span> with PCOS because it can be affected by multiple PCOS-related factors. Dysbiosis of the gut microbiome may trigger PCOS symptoms via an underlying mechanism that may involve microbial metabolites, including </span></span>bile acids<span><span><span>, short-chain fatty acids, and lipopolysaccharides. The manipulation of the gut microbiome can affect PCOS phenotypes, and </span>prebiotic or </span>probiotic therapy has the potential to improve PCOS symptoms. Future mechanistic studies are required to identify the causative role of these microbes and their metabolites in the pathogenesis of PCOS.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 214-226"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49277867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we approaching automated assisted reproductive technology? Sperm analysis, oocyte manipulation, and insemination","authors":"Valentina Casciani Ph.D. ,&nbsp;Daniela Galliano M.D., Ph.D. ,&nbsp;Jason M. Franasiak M.D. ,&nbsp;Giulia Mariani M.D. ,&nbsp;Marcos Meseguer Ph.D.","doi":"10.1016/j.xfnr.2021.03.002","DOIUrl":"10.1016/j.xfnr.2021.03.002","url":null,"abstract":"<div><p>Assisted reproductive technology (ART) procedures are mostly performed manually and require meticulous attention to details and precision in handling and timing. Automation of ART procedures would allow achieving standardization and reducing performance variability, the cost of medical treatment, and the risk of human error.</p><p><span>Some ART diagnostic devices are already available and offer objective tools of evaluation. However, automation of the entire spectrum of ART procedures is yet to come and can only be imagined as a platform capable of integrating all the separate technologies, successfully interconnecting them to guarantee a continued chain of custody of the gametes and embryos. The present update seeks to review the current potential for automation within the in vitro fertilization laboratory, with attention to sperm and oocyte manipulation and selection and to oocyte </span>insemination<span><span> with standard in vitro fertilization or intracytoplasmic sperm injection. An electronic search of PubMed was performed to identify articles in English that addressed automation in ART. Studies were classified in categories as </span>randomized controlled trials, prospective controlled trials, prospective noncontrolled trials, retrospective studies, and experimental studies. Research and development data from the authors are included.</span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 189-203"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44174712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of racial and ethnic disparities in reproductive endocrinology and infertility: where do we stand today?","authors":"Tia Jackson-Bey M.D., M.P.H. ,&nbsp;Jerrine Morris M.D., M.P.H. ,&nbsp;Elizabeth Jasper Ph.D. ,&nbsp;Digna R. Velez Edwards Ph.D., M.S. ,&nbsp;Kim Thornton M.D. ,&nbsp;Gloria Richard-Davis M.D. ,&nbsp;Torie Comeaux Plowden M.D., M.P.H.","doi":"10.1016/j.xfnr.2021.05.001","DOIUrl":"10.1016/j.xfnr.2021.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>To conduct a comprehensive review of racial and ethnic health disparities in infertility care and treatment.</p></div><div><h3>Evidence Review</h3><p>Systematic literature searches were performed in PubMed and Embase from inception to April 2021. Studies were eligible for inclusion if they were original research performed in humans, observational study design, focused on circumstances contributing to infertility, access to infertility care, or outcomes of infertility treatment, and provided relevant information on racial or ethnic groups. Titles and abstracts were reviewed independently by two reviewers to identify pertinent articles. In addition, references of included articles were screened.</p></div><div><h3>Result(s)</h3><p>The PubMed search yielded 2,113 articles. An additional 2,301 articles were found in the Embase search. In total, 4,414 articles were screened on the basis of title and, where necessary, abstract. Thirty-four were found to meet the inclusion criteria and included in this review. Three additional studies were found from searching references of the included articles, resulting in 37 articles for discussion: 26 retrospective cohort studies, 2 prospective cohort studies, and 9 cross-sectional studies. The overall consensus in the literature is that reproductive health disparities on the basis of race and ethnicity impact fertility, access to care, and fertility treatment outcomes.</p></div><div><h3>Conclusion(s)</h3><p>Racial and ethnic differences in access to full-spectrum reproductive care, including infertility evaluation and treatment, remain. Despite access to infertility treatment, disparate treatment outcomes persist. Intrinsic and extrinsic factors, such as the institutionalization of racism and discrimination within medicine, remain influential in the diagnosis, care, and treatment outcomes of individuals with infertility. To address these inequities, we should mitigate provider bias, fund high-quality health disparity research, improve patient reproductive health knowledge, and advocate for increased access to treatment for all.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 169-188"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42314428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared genetics between nonobstructive azoospermia and primary ovarian insufficiency","authors":"Lauren Verrilli M.D. ,&nbsp;Erica Johnstone M.D., M.H.S. ,&nbsp;Kristina Allen-Brady Ph.D., M.S.P.H, M.P.T. ,&nbsp;Corrine Welt M.D.","doi":"10.1016/j.xfnr.2021.04.001","DOIUrl":"10.1016/j.xfnr.2021.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Primary ovarian insufficiency<span><span><span> (POI) and nonobstructive azoospermia<span><span> (NOA) both represent disease states of early, and often complete, failure of gametogenesis. Because </span>oogenesis and </span></span>spermatogenesis share the same conserved steps in meiosis I, it is possible that inherited defects in meiosis I could lead to shared causes of both POI and NOA. Currently, known genes that contribute to both POI and NOA are limited. In this review article, we provide a </span>systematic review of genetic mutations in which both POI and NOA phenotypes exist.</span></p></div><div><h3>Evidence Review</h3><p>A PubMed literature review was conducted from January 1, 2000, through October 2020. We included all studies that demonstrated human cases of POI or NOA due to a specific genetic mutation either within the same family or in separate families.</p></div><div><h3>Results</h3><p>We identified 33 papers that encompassed 10 genes of interest with mutations implicated in both NOA and POI. The genes were all involved in processes of meiosis I.</p></div><div><h3>Conclusion</h3><p>Mutations in genes involved in processes of meiosis I may cause both NOA and POI. Identifying these unique phenotypes among shared genotypes leads to biologic plausibility that the key error occurs early in gametogenesis with an etiology shared among both male and female offspring. From a clinical standpoint, this shared relationship may help us better understand and identify individuals at a high risk of gonadal failure within families and suggests that clinicians obtain the history of opposite-sex family members when approaching a new diagnosis of POI or NOA.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 3","pages":"Pages 204-213"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 may affect male fertility but is not sexually transmitted: a systematic review","authors":"Ilan Tur-Kaspa M.D. ,&nbsp;Tomer Tur-Kaspa ,&nbsp;Grace Hildebrand B.A. ,&nbsp;David Cohen M.D.","doi":"10.1016/j.xfnr.2021.01.002","DOIUrl":"10.1016/j.xfnr.2021.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>To determine if SARS-CoV-2, which has led to the rapidly spreading COVID-19 global pandemic, is sexually transmitted. Since the putative receptor for the virus is identified in reproductive organs, it is also important to examine if COVID-19 may affect human fertility.</p></div><div><h3>Evidence Review</h3><p>A systematic review of English publications was conducted up to December 11, 2020 in PubMed, NIH iCite COVID-19 portfolio, Cochrane Library, and Google Scholar databases, searching for SARS-CoV-2 in the testes; seminal, prostatic, and vaginal fluids; and cervical smears. A total of 1,997 records were identified, duplicates were removed, and 1,490 records were reviewed for eligibility by examining titles and abstracts. Subsequently, 202 full-text relevant articles were reviewed by 2 independent reviewers. Forty-seven studies (literature reviews, editorials, and guidelines) were assessed qualitatively, and 23 studies that tested the male and female reproductive tracts of patients with COVID-19 for SARS-CoV-2 were quantitatively analyzed.</p></div><div><h3>Results</h3><p>No epidemiological investigations to date have described evidence suggesting that COVID-19 is an STD. While angiotensin-converting enzyme 2 receptor is found in the reproductive organs, the lack of co-expression of the TMPRSS2 modulatory protein, required for SARS-CoV-2 cell entry, in testicular cells, sperm, or oocytes, argues against the hypothesis that gametes transmit SARS-CoV-2. Molecular detection studies of SARS-CoV-2 RNA in the male and female reproductive tracts were summarized: 98.0% (293/299) of the seminal fluids, 16/17 testicular biopsies, all 89 prostatic fluids, 98.3% (57/58) of the vaginal fluids, all 35 cervical smears, and all 16 oocyte samples tested negative for SARS-CoV-2. None of the studies confirmed sexual transmission of SARS-CoV-2. Nonetheless, COVID-19 may have detrimental effects on male reproduction by inducing orchitis and/or decreasing testosterone levels, sperm counts, and motility.</p></div><div><h3>Conclusion</h3><p>On the basis of the current worldwide published information, COVID-19 is not an STD. This information is important for clinicians, proposed guidelines for public health, U.S. Food and Drug Administration guidelines for gamete and tissue donor eligibility, and fertility treatments. Universal precautions, currently practiced worldwide, are adequate and sufficient at this time to prevent the transmission of known or unknown viral infections. We suggest that recovered patients of COVID-19, especially those with infertility, should be evaluated for their ovarian and testicular function.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 2","pages":"Pages 140-149"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25349155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}