Antiphospholipid Antibodies and Outcomes of Assisted Reproductive Technology Programs in Patients with a History of Covid-19

Investigation of the effect COVID-19 mediated with autoantibodies has on reproductive outcomes is important. This study aimed to evaluate the profile of antiphospholipid antibodies (aPL) and their association with the outcomes of assisted reproductive technology (ART) programs in patients with a history of COVID-19. The study included 240 patients: 105 of them did not have a history of COVID-19 (group 1) and 135 of them had a history of COVID-19 (group 2) with a mild course (subgroup 2a, n = 85) or moderate course (subgroup 2b, n = 50). With the help of ELISA, serum antibodies (M, G) to cardiolipin, beta 2-glycoprotein-I, annexin V (AnV), phosphatidylethanolamine (PE), phosphatidylserine, and phosphatidylserine/prothrombin complex were determined. The evaluated parameters were the indices of oogenesis, embryogenesis, ART intervention outcomes. In group 2, growing levels of anti-AnV and anti-PE IgG were observed more often (in 28 (20.7%) and 8 (5.9%) patients) than in group 1 (in 10 (9.5%) and 1 (0.95%);p = 0.02 and p = 0.045, respectively). In subgroup 2b we registered a higher level of anti-PE IgG and a higher incidence of early miscarriages (in 6 (12%) patients) than in group 1 (in 3 (2.9%)) (p = 0.024). Weak inverse correlations were found between the level of anti-PE IgG and the number of oocytes and zygotes. The results of this study suggest a negative impact of aPL-mediated COVID-19 on the outcomes of ART programs and the course of early pregnancy.

ANTIBODIES TO ANGIOTENSIN-CONVERTING ENZYME 2 IN INFERTILE PATIENTS WITH A HISTORY OF COVID-19 AND IN FERTILE WOMEN.

Angiotensin-converting enzyme 2 (ACE2) is a key component of the renin-angiotensin system (RAS) that affects fertility in women. Antibodies against ACE2 have predictive value for COVID-19 and may contribute to RAS dysregulation and reproductive failure. Objective(s): To investigate the prevalence and levels of anti-ACE2 autoantibodies in infertile patients with a history of COVID-19 and in fertile women. Material(s) and Method(s): Serum anti-ACE2 autoantibodies (M, G) were determined by ELISA in infertile patients with a history of COVID-19 (group 1, n=121), without a history of COVID-19 (group 2, n=79), and in fertile women (group 3, n=80). The association between antibodies against ACE2, SARS-CoV-2, thyroid antigens, and hormones was investigated. Result(s): Patients in groups 1 and 2 had higher rates of inflammatory gynecologic diseases, pelvic surgery, spontaneous miscarriages, and thyroid pathology than those in group 3. Anti-ACE2 antibodies were detected more frequently (40.5% and 38.8 %) and had higher levels in infertile patients than in fertile women (20%). Women with a history of COVID-19 were more likely to have anti-ACE2 IgG. Antibodies against ACE2 were significantly correlated with those against FSH. Conclusion(s): Patients with infertility, irrespective of a history of COVID-19, have a higher prevalence and higher anti-ACE2 antibody levels than fertile women. Anti-ACE2 antibodies are associated with primary and secondary infertility, and may be involved in the pathophysiology of infertility.Copyright © A group of authors, 2023.

ANTIBODIES TO ANGIOTENSIN-CONVERTING ENZYME 2 IN INFERTILE PATIENTS WITH A HISTORY OF COVID-19 AND IN FERTILE WOMEN.

Angiotensin-converting enzyme 2 (ACE2) is a key component of the renin-angiotensin system (RAS) that affects fertility in women. Antibodies against ACE2 have predictive value for COVID-19 and may contribute to RAS dysregulation and reproductive failure. Objective(s): To investigate the prevalence and levels of anti-ACE2 autoantibodies in infertile patients with a history of COVID-19 and in fertile women. Material(s) and Method(s): Serum anti-ACE2 autoantibodies (M, G) were determined by ELISA in infertile patients with a history of COVID-19 (group 1, n=121), without a history of COVID-19 (group 2, n=79), and in fertile women (group 3, n=80). The association between antibodies against ACE2, SARS-CoV-2, thyroid antigens, and hormones was investigated. Result(s): Patients in groups 1 and 2 had higher rates of inflammatory gynecologic diseases, pelvic surgery, spontaneous miscarriages, and thyroid pathology than those in group 3. Anti-ACE2 antibodies were detected more frequently (40.5% and 38.8 %) and had higher levels in infertile patients than in fertile women (20%). Women with a history of COVID-19 were more likely to have anti-ACE2 IgG. Antibodies against ACE2 were significantly correlated with those against FSH. Conclusion(s): Patients with infertility, irrespective of a history of COVID-19, have a higher prevalence and higher anti-ACE2 antibody levels than fertile women. Anti-ACE2 antibodies are associated with primary and secondary infertility, and may be involved in the pathophysiology of infertility.Copyright © A group of authors, 2023.

ANTIBODIES TO ANGIOTENSIN-CONVERTING ENZYME 2 IN INFERTILE PATIENTS WITH A HISTORY OF COVID-19 AND IN FERTILE WOMEN.

Angiotensin-converting enzyme 2 (ACE2) is a key component of the renin-angiotensin system (RAS) that affects fertility in women. Antibodies against ACE2 have predictive value for COVID-19 and may contribute to RAS dysregulation and reproductive failure. Objective(s): To investigate the prevalence and levels of anti-ACE2 autoantibodies in infertile patients with a history of COVID-19 and in fertile women. Material(s) and Method(s): Serum anti-ACE2 autoantibodies (M, G) were determined by ELISA in infertile patients with a history of COVID-19 (group 1, n=121), without a history of COVID-19 (group 2, n=79), and in fertile women (group 3, n=80). The association between antibodies against ACE2, SARS-CoV-2, thyroid antigens, and hormones was investigated. Result(s): Patients in groups 1 and 2 had higher rates of inflammatory gynecologic diseases, pelvic surgery, spontaneous miscarriages, and thyroid pathology than those in group 3. Anti-ACE2 antibodies were detected more frequently (40.5% and 38.8 %) and had higher levels in infertile patients than in fertile women (20%). Women with a history of COVID-19 were more likely to have anti-ACE2 IgG. Antibodies against ACE2 were significantly correlated with those against FSH. Conclusion(s): Patients with infertility, irrespective of a history of COVID-19, have a higher prevalence and higher anti-ACE2 antibody levels than fertile women. Anti-ACE2 antibodies are associated with primary and secondary infertility, and may be involved in the pathophysiology of infertility.Copyright © A group of authors, 2023.

Antiphospholipid Antibodies and Outcomes of Assisted Reproductive Technology Programs in Patients with a History of Covid-19

Investigation of the effect COVID-19 mediated with autoantibodies has on reproductive outcomes is important. This study aimed to evaluate the profile of antiphospholipid antibodies (aPL) and their association with the outcomes of assisted reproductive technology (ART) programs in patients with a history of COVID-19. The study included 240 patients: 105 of them did not have a history of COVID-19 (group 1) and 135 of them had a history of COVID-19 (group 2) with a mild course (subgroup 2a, n = 85) or moderate course (subgroup 2b, n = 50). With the help of ELISA, serum antibodies (M, G) to cardiolipin, beta2-glycoprotein-I, annexin V (AnV), phosphatidylethanolamine (PE), phosphatidylserine, and phosphatidylserine/prothrombin complex were determined. The evaluated parameters were the indices of oogenesis, embryogenesis, ART intervention outcomes. In group 2, growing levels of anti-AnV and anti-PE IgG were observed more often (in 28 (20.7%) and 8 (5.9%) patients) than in group 1 (in 10 (9.5%) and 1 (0.95%);p = 0.02 and p = 0.045, respectively). In subgroup 2b we registered a higher level of anti-PE IgG and a higher incidence of early miscarriages (in 6 (12%) patients) than in group 1 (in 3 (2.9%)) (p = 0.024). Weak inverse correlations were found between the level of anti-PE IgG and the number of oocytes and zygotes. The results of this study suggest a negative impact of aPL-mediated COVID-19 on the outcomes of ART programs and the course of early pregnancy. Copyright © 2022 Pirogov Russian National Research Medical University. All rights reserved.

THE IMPACT OF COVID-19 ON THE OVARIAN RESERVE IN WOMEN

Objective: To investigate ovarian reserve and menstrual function in women with COVID-19 of various severity. Material(s) and Method(s): This prospective study analyzed parameters of ovarian reserve (AMH, FSH, and the AFC) and menstrual cycle (cycle length, menstrual duration) in 41 patients before and after COVID-19 disease. The interval between measurements was 6-12 months. Mild and moderate COVID-19 was observed in 31 (group 1) and 10 (group 2) patients. The inclusion criteria were age 18-45 years, preserved menstrual function. Non-inclusion criteria were decreased ovarian reserve before the onset of COVID-19 (AMH<1.2 ng/mL, AFC<5), a history of COVID-19 vaccination, pregnancy and lactation, severe somatic and infectious comorbidities affecting ovarian reserve. Result(s): In patients of late reproductive age (LRA) (>35 years), COVID-19 was associated with a reduction in ovarian reserve. Furthermore, patients with more severe COVID-19 had a more pronounced decrease in AFC. When simultaneously assessing the effect of infection severity and age on ovarian reserve, it was found that LRA patients with a more severe form of infection had the biggest decrease in ovarian reserve. The menstrual cycle did not change significantly. Conclusion(s): The study findings reflect the impact of both age and severity of COVID-19 on ovarian reserve in women. In women of LRA, a decrease in ovarian reserve can occur spontaneously, and the time difference can be very significant. Therefore, one cannot accurately state that ovarian reserve reduction was due to the disease. Nevertheless, the effect of infection severity on the degree of ovarian reserve reduction suggests an adverse effect of SARS-CoV-2 on ovarian function in women. Copyright © A group of authors, 2022.

THE IMPACT OF COVID-19 ON THE OUTCOMES OF ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS

Objective: To investigate the outcomes of assisted reproductive technology (ART) programs in patients with a history of COVID-19 of various severity. Material(s) and Method(s): This prospective study enrolled 240 infertile patients. They were divided into group 1 comprising patients without a history of COVID-19 (n=105) and group 2 (n=135) including patients who less than 12 months before the ART cycle had mild (subgroup 2a, n=85) or moderate (subgroup 2b, n=50) COVID-19. The level of specific antibodies to SARS-CoV-2, parameters of oogenesis, early embryogenesis, and clinical outcomes of HRT were evaluated. Result(s): The parameters of oogenesis and embryogenesis, pregnancy and delivery rates did not differ between groups 1 and 2. A weak negative correlation was detected between the level of IgG-antibodies to SARS-CoV-2 and the number of obtained oocytes and embryos. Patients with an interval between COVID-19 and ART cycle <=6 months had a significantly higher relative number of poor-quality blastocysts than women with >6 months interval. Patients who experienced moderate COVID-19 had a high early miscarriage rate of (12%). Conclusion(s): COVID-19 can adversely affect reproductive outcomes, lead to a decrease in the number of oocytes and embryos obtained in ART cycles and their quality, and increase the risk of early miscarriage. More research is needed to investigate the mechanisms underlying the adverse effects of COVID-19 and the post-COVID syndrome. Copyright © A group of authors, 2022.