The impact of Covid-19 on gametes and endometrium: a narrative review

Abstract

The Coronavirus disease 2019 (COVID-19) has been affecting our lives since December 19. Naturally, during the COVID-19 outbreak, it has become a point of interest whether severe acute respiratory syn- drome-coronavirus-2 (SARS-CoV-2) infection might affect oocyte, and sperm and influence the implan- tation during the assisted reproductive technology cycles. In the current narrative review, we aimed to scrutinize articles about SARS-CoV-2 infection and infertility concerning the safety of gametes and the endometrium. Whereas the available data suggest that SARS-CoV-2 interferes with various types of molecular pathways in the oocyte, spermatozoa, and endometrium, the lack of co-expression in an- giotensin-converting enzyme 2 and transmembrane protease serine 2 in those cell lines theoretically avoid concerns by patients and reproductive endocrinologists. However, one should consider that those observations were based on a few case series and should be confirmed with further observational stud- ies including a larger sample size with various clinic spectrums. Alternative pathways that can be utilized by the virus to invade gametes and individual differences in molecular expression are other potential lim- itations that should be considered.