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The recent COVID-19 pandemic led to many drastic changes in not only society, law, economics, but also in science and medicine, marking for the first time when drug regulatory authorities cleared for use mRNA-based vaccines in the fight against this outbreak. However, while indeed representing a novel application of such technology in the context of vaccination medicine, introducing RNA into cells to produce resultant molecules (proteins, antibodies, etc.) is not a novel principle. It has been common practice to introduce/inject mRNA into oocytes and embryos to inhibit, induce, and identify several factors in a research context, while such aspects have also been proposed as potential therapeutic and diagnostic applications to combat infertility in humans. Herein, we describe key areas where mRNA-based platforms have thus far represented potential areas of clinical applications, describing the advantages and limitations of such applications. Finally, we also discuss how recent advances in mRNA-based platforms, driven by the recent pandemic, may stand to benefit the treatment of infertility in humans. We also present brief future directions as to how we could utilise recent and current advancements to enhance RNA therapeutics within reproductive biology, specifically with relation to oocyte and embryo delivery.
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Background: Infectious bronchitis (IB) is an acute and highly contagious viral disease of poultry affecting chicken of all ages. The causative agent IB virus (IBV) is a Gammacoronavirus within the family Coronaviridae. Viral genetic mutations and recombination events particularly in the spike protein (S1) of IBV constantly give rise to emerging IBV variants. Vaccination is considered as the most reliable approach for IBV control, but current vaccines have been found to be ineffective due to constant emergence of new variant viruses. Objective(s): The objective of our study was to detect IBV genotypes prevalent in Assam, India. Material(s) and Method(s): Oro-pharyngeal swabs and tissue samples from unvaccinated broiler chickens showing respiratory symptoms were tested using RT-PCR targeting the N gene of IBV. The virus was isolated from infected swab/tissue samples in 9 days old specific pathogen free embryonated chicken eggs through allantoic cavity route. Phylogenetic studies were done based on the S1 gene of IBV. Results and Conclusion(s): Clinically, the birds showed gasping and tracheal rales. Necropsy revealed distended ureters. Virus was isolated and identified by curling and dwarfing of the dead embryos and further confirmed by RT-PCR. Positive PCR amplicons were sequenced and phylogenetic analysis clustered the IBV isolate from Assam with genotype I lineage 1 IBV prototype sequence belonging to Beaudette and Mass 41 strains but the isolate exhibited a relatively high degree of sequence divergence with reference strains. Our findings suggest that the IBV isolate might have emerged from recombination with the local circulating virus or vaccine strains. This will have important implications for IB prevention strategies.
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OBJECTIVE: This study aimed to investigate the accuracy of convolutional neural network models in the assessment of embryos using time-lapse monitoring. DATA SOURCES: A systematic search was conducted in PubMed and Web of Science databases from January 2016 to December 2022. The search strategy was carried out by using key words and MeSH (Medical Subject Headings) terms. STUDY ELIGIBILITY CRITERIA: Studies were included if they reported the accuracy of convolutional neural network models for embryo evaluation using time-lapse monitoring. The review was registered with PROSPERO (International Prospective Register of Systematic Reviews; identification number CRD42021275916). METHODS: Two reviewer authors independently screened results using the Covidence systematic review software. The full-text articles were reviewed when studies met the inclusion criteria or in any uncertainty. Nonconsensus was resolved by a third reviewer. Risk of bias and applicability were evaluated using the QUADAS-2 tool and the modified Joanna Briggs Institute or JBI checklist. RESULTS: Following a systematic search of the literature, 22 studies were identified as eligible for inclusion. All studies were retrospective. A total of 522,516 images of 222,998 embryos were analyzed. Three main outcomes were evaluated: successful in vitro fertilization, blastocyst stage classification, and blastocyst quality. Most studies reported >80% accuracy, and embryologists were outperformed in some. Ten studies had a high risk of bias, mostly because of patient bias. CONCLUSION: The application of artificial intelligence in time-lapse monitoring has the potential to provide more efficient, accurate, and objective embryo evaluation. Models that examined blastocyst stage classification showed the best predictions. Models that predicted live birth had a low risk of bias, used the largest databases, and had external validation, which heightens their relevance to clinical application. Our systematic review is limited by the high heterogeneity among the included studies. Researchers should share databases and standardize reporting.
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Background: B814, now's called Coronavirus first identified by Tyrrell and Bynoe in 1965 from the respiratory tract (embryonic tracheal) of an adult and later on during working on National Institutes of Health Robert Chanock used the term "OC" for same virus strain. After several years researchers reported that coronaviruses were caused disease in rats, mice, chickens, turkeys, calves, dogs, cats, rabbits etc. after effecting the enormous variety of animal, in year 2002-2003 it caused new respiratory disease named severe acute respiratory syndrome, (SARS) in southern China. Objective(s): The main objective of this article is to compare the status of various previous pandemics (i.e., SARS, MERS) with the current COVID-19 pandemic in terms of the life cycle, diagnosis process and prevention Results: On 31st December 2019, the World Health Organization (WHO) office in China received information regarding pneumonia cases of unknown etiology from the Wuhan district in central China. Subsequently, this new disease spread to China, and from there, to the rest of the world. By the end of March 2020, more than 2 million cases were confirmed of this new disease, with over 70000 deaths worldwide. After some time, researchers have identified that this new disease is caused by a novel beta-Coronavirus (virus SARS-CoV-2) and the new disease was named COVID-19. Since then, the Ministry of Health of various countries and WHO have been fighting this health emergency, which has not only affected public health, but also affected various economic sectors. Conclusion(s): The current outbreak SARS-CoV-2 phylogenetically resembled to Bat SARS, which was previously identified in year 2002 and 2012 having low mortality rate than MERS and SARS. However, SARS-CoV-2 and MERS having high virological similarity but both use different receptors to take entry in to the host cell via ACE-2 and DPP-4 respectively. Unfortunately, currently there is no approved treatment available worldwide. Currently, we can hope that together we will recover from this public health emergency very soon.Copyright © 2021 Bentham Science Publishers.
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Aplasia cutis congenita (ACC) is often sporadic, but familial cases have been reported. We report a case of a dichorionic diamniotic twin pregnancy in which both the male and female twins had matching areas of aplasia cutis on their scalps. An Irish couple sought fertility treatment using a donor egg and paternal sperm. Successful in vitro fertilization (IVF) and the transfer of two embryos resulted in a diamniotic dichorionic twin pregnancy. Two fetal poles were noted at the 12-week ultrasound (US) scans. The mother suffered from a minor urinary tract infection during the first trimester but had no other history of infection, including herpes simplex virus or COVID- 19. She was known to be varicella immune prior to pregnancy. The twins were born by elective caesarean section owing to breech presentation. Twin one was female and twin two was male. Both infants were born with scarring on the crown of their head, which was consistent with ACC. Cranial US showed no underlying bony abnormality. The rest of the cutaneous examination was normal and there were no other congenital anomalies. ACC is a rare, heterogeneous group of disorders characterized by the congenital absence of skin, which can be focal or widespread. It is thought to affect 1-3 per 10 000 live births. The exact cause of ACC is unclear. Various hypotheses have been suggested, including defective closure of the neural tube or embryonic fusion lines, intrauterine trauma, placental insufficiency, fetus papyraceus, amniotic membrane adhesions, intrauterine infections, teratogens and genetic mutations. The classification of ACC is based on the area affected, type of skin irregularity, associated congenital defects and mode of inheritance. Scalp ACC without multiple anomalies (category 1) is generally associated with an autosomal dominant or sporadic pattern of inheritance. These twins may have an autosomal dominant mutation that led to this phenotype. ACC can also be associated with fetus papyraceus or placental infarct. This is less likely in this case as only two embryos were transferred, and the pregnancy was dichorionic. Most cases of ACC associated with fetus papyraceus occur in monozygotic pregnancies. ACC lesions often heal spontaneously by re-epithelialization resulting in a hairless superficial scar. Twin one had a slightly smaller area affected by ACC and overlying eschar resolved several weeks after birth. Twin two has had no hair growth in the area. This case highlights the difficulties in ascertaining the aetiology of this rare condition in twin pregnancies.
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Objective. As the SARS-CoV-2 Pandemic has widely changed pregnancy experience and assessment, the inpatient and outpatient services have had to be re-organized. Since March 2020, Careggi University Hospital (CUH) has provided a dedicated COVID-pathway: spaces for women with unknown swab status and a COVID-19 ward delivery room. The aim of this study is to analyze the inpatient and outpatient COVID-19 related activities in CUH. Materials and Methods. We prospectively collected data from consecutive COVID-19 pregnancies referred from 2020 to 2022, included in the local branch of the ItOSS surveillance. All patients experienced COVID-19 in pregnancy at various stages of severity and gestational ages. Results. From March 2020 to June 2022, 165 COVID-19 deliveries occurred (169 newborns), while 16 pregnant positive women were admitted without delivering. A single emergency C-section (CS) was performed because of Sars-CoV-2 related ARDS, 15 women experienced serious maternal morbidity and 5 needed ECMO. A single maternal death occurred four months after delivery (C-section). Considering ECMO supported cases during pregnancy or postpartum, the first one tested positive for COVID-19 during the second trimester. She developed ARDS and required ECMO for 38 days. She was discharged in good general conditions and a CS at term was performed following obstetric indication. The second patient developed COVID-19-related ARDS at 28 weeks of gestation and experienced a precipitous vaginal delivery at 31 weeks+6 days of gestation while on ECMO. She was discharged 1 month later in good general conditions. The third patient was an obese (BMI 38) 43-year-old woman who had performed an IVF with embryo donation;she tested positive at 38 weeks+2 days of gestation. A CS was performed because of the worsening of her condition. After the delivery she was admitted in ICU and she underwent ECMO. She died 143 days after the CS by sepsis and multiple organ failure (MOF). For all these pregnancies neonatal outcomes were positive. No perinatal death occurred and only one baby tested positive for SARS-CoV-2 infection at nasal swab sampling (case 3). The anesthesiology team performed neuroassial analgesia intrapartum in all the positive women who needed/requested it. Monoclonal Antibodies (mAbs) have been widely used to treat mild to moderate COVID-19 outpatients (NIH and RCOG recommendations) at risk for developing severe disease. Regarding this specifical therapy, an essential role in the management of the pregnant outpatient was played by the Infectious Disease Department. All patients above 28 weeks requiring hospitalization received LMWH prophylaxis, which was administrated under 28 weeks only in presence of additional risk factors (obesity, IVF, etc.). All new mothers received a ten days LMWH prophylaxis. On the outpatient side, we performed 22 teleconsultations, 43 obstetric ultrasounds (including I trimester screening), 90 obstetric checks with clinical evaluation and home therapy management, 32 fetal monitoring and 47 naso-pharingeal swabs. Conclusions. At Careggi Hospital Maternal Department an extensive re-organization of inpatient and outpatient services has been performed in order to guarantee good practice and management of all pregnant women during the SARS-CoV-2 pandemic. This was only possible thanks to a wide multidisciplinary group which enhanced every professional.
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BACKGROUND: Cross-border surrogacy and egg donor arrangements are an increasingly common means to family building. Establishing patterns of use has always been difficult in relation to Australian patients. Accurate data is stymied by lack of documentation of international third-party reproductive care available to Australian authorities. When international travel bans came into effect, it is hypothesised that those planning to use cross-border reproductive care had to rely significantly more on local in vitro fertilisation (IVF) clinics for services such as sperm freezing, embryo creation and gamete release procedures. AIM: To quantify and characterise the impact of the Covid-19-related travel ban on international and interstate gamete shipping by Australian IVF clinics. MATERIALS AND METHODS: Thirty-one Australian and New Zealand IVF clinics were invited to provide de-identified data on interstate and international gamete export applications from two 12 month time periods pre- and during Covid-19-related international travel lockdowns. Seven IVF organisations provided data on: patient age; type of gametes exported; destination country/state; and date gamete release approved. RESULTS: Most gametes (78%) were shipped to another Australian IVF clinic and 22% internationally. Patient-initiated shipping domestically and internationally both showed significant increases when comparing pre- and post-Covid datasets. Of the 21 destination countries reported for international shipments, the US was the commonest (39%), followed by Ukraine (21%) and Canada (9%). CONCLUSIONS: The inability of involuntarily infertile patients to travel internationally, rather than halt cross-border reproductive care, has led to a significant increase in the uptake of gamete shipping. The high proportion of internationally shipped gametes going to the US and Ukraine is likely a reflection of the availability of surrogates and donors and more amenable legal frameworks.
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BACKGROUND: In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE: This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS: PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES: From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS: This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
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There is insufficient data on the impact of severe acute respiratory coronavirus-2 (SARS-CoV-2) on the reproductive tissues, its possible risk of cross-contamination, transmission and adverse effect on in vitro fertilization (IVF) outcome. Until today, there is no report associated with viral RNA in both follicular fluid and embryo culture medium from SARS-COV-2 positive women. In this case report, a 24-year-old woman with SARS-CoV-2 was presented. We investigated the SARS-COV-2 positivity in the follicular fluid and embryo culture medium of mildly symptomatic woman on oocyte pick up (OPU) day. We could not detect viral RNA in neither the follicular fluid nor the embryo culture medium. In addition, although the response of ovarian stimulation was normal, the number and maturity of the retrieved oocytes were low.
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BACKGROUND: Remdesivir is an antiviral drug approved for the treatment of COVID-19, whose developmental toxicity remains unclear. More information about the safety of remdesivir is urgently needed for people of childbearing potential, who are affected by the ongoing pandemic. Morphogenetic embryoid bodies (MEBs) are three-dimensional (3D) aggregates of pluripotent stem cells that recapitulate embryonic body patterning in vitro, and have been used as effective embryo models to detect the developmental toxicity of chemical exposures specifically and sensitively. METHODS: MEBs were generated from mouse P19C5 and human H9 pluripotent stem cells, and used to examine the effects of remdesivir. The morphological effects were assessed by analyzing the morphometric parameters of MEBs after exposure to varying concentrations of remdesivir. The molecular impact of remdesivir was evaluated by measuring the transcript levels of developmental regulator genes. RESULTS: The mouse MEB morphogenesis was impaired by remdesivir at 1-8 µM. Remdesivir affected MEBs in a manner dependent on metabolic conversion, and its potency was higher than GS-441524 and GS-621763, presumptive anti-COVID-19 drugs that act similarly to remdesivir. The expressions of developmental regulator genes, particularly those involved in axial and somite patterning, were dysregulated by remdesivir. The early stage of MEB development was more vulnerable to remdesivir exposure than the later stage. The morphogenesis and gene expression profiles of human MEBs were also impaired by remdesivir at 1-8 µM. CONCLUSIONS: Remdesivir impaired mouse and human MEBs at concentrations that are comparable to the therapeutic plasma levels in humans, urging further investigation into the potential impact of remdesivir on developing embryos.
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Nirmatrelvir (PF-07321332;NMV) the antiviral component of PAXLOVID PACK is a potent and selective inhibitor of the SARSCoV- 2 main protease (Mpro), which plays a critical role in viral replication. PAXLOVID PACK, comprised of nirmatrelvir and ritonavir (used as a pharmacokinetic enhancer), is an oral therapy currently in development as a therapeutic option for those infected with SARS-CoV-2 to prevent progression to severe disease, hospitalization, and death. It is also being tested for its potential benefit in the post-exposure prophylactic setting. Given that males and females of reproductive age are included in the intended patient population, we assessed the potential effects of NMV up to the limit dose of 1000 mg/kg/day in ICH guideline embryo-fetal development studies in rats and rabbits, and a fertility and early embryonic development study in rats. There were no effects on male and female fertility or early embryonic development in rats, and no severe manifestations of developmental toxicity in rats or rabbits. The lack of adverse findings reported here in nonclinical species is consistent with the intended therapeutic target of NMV (a virus specific protein not present in mammalian cells), the favorable off-target selectivity profile, and lack of genetic toxicity. All procedures performed on the animals in these studies were in accordance with regulations and established guidelines and were reviewed and approved by an Institutional Animal Care and Use Committee or through an ethical review process.
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Background: Women are increasingly electing to cryopreserve oocytes in order to delay childbearing. Planned oocyte cryopreservation often requires significant investment, yet there is a paucity of data to guide patients on their likelihood of obtaining significant returns. In addition, the prediction of live birth rates after using cryopreserved oocytes remains an area of active investigation. Objective(s): We aimed to characterize patterns in planned oocyte cryopreservation over the last decade, determine the percentage of patients who returned to utilize cryopreserved oocytes, and develop a counseling tool for patients on the anticipated number of cryopreserved oocytes based on age and AMH. Material(s) and Method(s): We performed a retrospective review of women undergoing planned oocyte cryopreservation at a single, large, university-affiliated REI practice from January 2010 to December 2020. Oocyte cryopreservation for cancer diagnosis, TESE failure, or inability to produce a semen sample on the day of oocyte retrieval were excluded. The primary outcome was the percentage of patients who returned to utilize cryopreserved oocytes for fertilization and subsequent embryo transfer or PGT-A. Secondary outcomes were the number of planned oocyte cryopreservation cycles per year, the number of oocyte thaw/warm cycles per year, and the mean number of cryopreserved oocytes based on age (<25, 25-30, 30-35, 35-42, >42) and AMH (<0.5 ng/mL, 0.5-1 ng/mL, 1-3.5 ng/mL, >3.5 ng/mL). Result(s): 2,845 planned oocyte cryopreservation cycles were performed between January 2010 and December 2020. The mean patient age at cycle start was 36.6 +/- 3.6 years. The number of oocyte cryopreservation cycles increased from 2010 (n=9) to 2019 (n=499). The number of oocyte thaw/warm cycles similarly increased between 2010 (n=1) and 2019 (n=100), and the majority of thaw/warm cycles (77.3%) took place within the last three years (2018-2020). Notably, 2020 witnessed a decrease in both planned oocyte cryopreservation (n=215) and oocyte thaw/warm (n=84) cycles due to the COVID-19 pandemic. AMH was the strongest predictor of the mean number of cryopreserved oocytes, and the highest yield (mean 18.6) occurred in patients 30-35 years old with an AMH >3.5 ng/mL. During the study period, 12.4% (267/2,159) of patients returned to utilize cryopreserved oocytes. Conclusion(s): The number of planned oocyte cryopreservation cycles increased each year between 2010 and 2019;however, a minority of women (12.4%) ultimately returned to utilize cryopreserved oocytes. Financial Support: None REFERENCES: 1. Leung, A.Q., Baker, K., Vaughan, D., Shah, J.S., Korkidakis, A., Ryley, D.A., Sakkas, D., Toth, T.L., 2021. Clinical outcomes and utilization from over a decade of planned oocyte cryopreservation. Reprod Biomed Online 43, 671-679. 2. Practice Committee of the American Society for Reproductive Medicine. Electronic address:, 2021. Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline. Fertil Steril 116, 36-47. Copyright © 2022
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Avian infectious bronchitis virus (IBV), a chicken Gammacoronavirus, is a major poultry pathogen, and is probably endemic in all regions with intensive poultry production. Since IBV was first described in 1936, many serotypes and variants of IBV have been isolated worldwide. IBV isolates are capable of infecting a large range of epithelial surfaces of the chicken, involving the respiratory, renal, and reproductive systems;however, the clinical signs are usually not specific for differential diagnoses. Virus isolation is commonly used for diagnosis of IBV infection, which was achieved through passage of clinical materials via the allantoic route of embryos. Currently, more sensitive molecular approaches for the detection of avian pathogens have been developed, including reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time RT-PCR, which are more suitable for use in diagnostic laboratories. In this chapter, we describe a one-step RT-PCR which can be used for detecting most of IBV serotypes in the IBV-infected allantoic fluid and has been used routinely in our laboratories for detection of IBVs. Copyright © Springer Science+Business Media New York 2016.
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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.
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Background: SARS-COVID-19 pandemic become a major health problem and impinge a large burden on health systems. SARS-CoV-2 utilize ACE2 receptors as a main port for its entry to the cells. These are widely spread in the body including ovaries. They are important for ovarian development. Therefore SARS-CoV-2 infection may have long term consequences of female's fertility and on parameters that determine ART outcomes. This study designed to display if there is a long term effect of this disease on ova and embryo qualities during ART procedures. Material(s) and Method(s): This is a cohort study enrolling 54 infertile women attending our institute for ICSI procedure. Parameters determine oocytes and embryo quality are recoded. Serum SARS-CoV-2 IgG measured and patient classified in those with negative (<1) and positive (>=1) groups. Result(s): There are no significant differences between cases with negative and positive SARS-CoV-2 IgG in parameters for oocytes and embryo quality: p value for oocytes no. 0.84, abnormal oocytes 0.25, germinal vesicles 0.46, MI 0.52, MII 0.75, number of embryo transfer 0.86, G1 embryo 0.82, maturation rate 0.79, and fertilization rate 0.61. Conclusion(s): There are no long term effect of SARS-CoV-2 infection on embryo and ova quality in patient have ART procedures. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: This study try to shed a light on long term consequence of SARS-CoV-2 infection through it IgG level in follicular fluid on oocytes and embryo quality in ICSI procedure. Material and methods: This is a cohort analytic study in comprising 54 infertile women attending our institute for ICSI procedure. Oocytes and embryo quality parameters are stated. Follicular fluid SARS-CoV-2 IgG measured and patient classified in low (0.6), medium (0.6-1) and high (>1) levels. Results: There are no significant differences between groups in maturation rate, fertilization index, number of oocytes is, number of germinal vesicles, number of M I, number of M II, and number of abnormal oocytes, grade I embryo and number of embryo transfer (p value is 0.85, 0.68, 0.99, 0.12, 0.426, 0.85, 0.77 0.77 0.88 respectively). Conclusion: This study figures out that SARS-CoV-2 infection have no long-term consequences on embryo and oocytes quality in ICSI procedure. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.
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OBJECTIVE: To investigate the effect of inactivated coronavirus disease 2019 (COVID-19) vaccination on frozen-thawed embryo transfer (FET) outcomes. METHODS: This retrospective cohort study enrolled 1,210 patients undergoing FET cycles in a single university-affiliated hospital between July 1, 2021, and May 1, 2022. Of them, 387 women with two full doses of inactivated SARS-CoV-2 vaccines (CoronaVac or BBIBP-CorV) after oocyte retrieval were assigned to the vaccinated group, while 823 were unvaccinated as controls. Propensity score matching and multiple regression analysis were applied to control for baseline and cycle characteristics (19 covariates in total). RESULTS: There were 265 patients in each group after matching. The rates of clinical pregnancy (58.5% vs. 60.8%; P = 0.595) and live birth (44.4% vs. 48.8%; P = 0.693) were similar between vaccinated and unvaccinated patients, with adjusted odds ratios of 0.89 (95% confidence interval [CI] 0.61-1.29) and 1.31 (95% CI 0.37-4.56), respectively. Consistently, no significant differences were found in serum human chorionic gonadotropin levels as well as biochemical pregnancy, biochemical pregnancy loss, and embryo implantation rates. Based on the time interval from vaccination to FET, vaccinated patients were further subdivided into two categories of ≤2 months and >2 months, and the outcomes remained comparable. CONCLUSION: Our study showed that inactivated COVID-19 vaccination in women did not have measurable detrimental impact on implantation performance and live birth outcome during FET treatment cycles. This finding denies the impairment of endometrial receptivity and trophoblast function by vaccine-induced antibodies at the clinical level.
Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Pregnancy , Humans , Female , Pregnancy Outcome , COVID-19 Vaccines , Pregnancy Rate , Retrospective Studies , COVID-19/prevention & control , SARS-CoV-2 , Embryo Transfer , Cryopreservation , Pregnancy Complications, Infectious/prevention & controlABSTRACT
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.
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Radiologic imaging in the evaluation of pregnant patients has significantly grown with the outbreak of the severe acute respiratory syndrome related to SARS-CoV-2 pandemic. Lung ultrasound is an emerging non-invasive bedside technique used to diag-nose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In pregnant COVID-19 patients, lung ultrasound should be considered on ac-count of its various strengths, such as its being easily carried out bedside by trained sonographers for the monitoring of lung involvement in follow-ups, and its repeatability and affordability. However, pregnant patients could need chest radiography or computed tomo-graphic (CT) examinations for the diagnosis of pneumonia. Concerns and mis-conceptions about potential radiation-related risks for the embryo or fetus are still widespread among clinicians and can lead to excessive anxiety among pa-tients. Several well-recognized guidance documents were published in the last years as to the safety of a single-phase CT or an X-ray chest and related carcino-genic and teratogenic risk. This paper summarizes the safety of radiological examination for pneumonia in pregnant women affected by COVID 19, based on the estimated embryo-fetal radiation absorption per procedure (mGy).
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Introduction: In the search of effective medicines against Coronavirus Disease-2019 (COVID-19) besides the conventional mode of treatment many medicines belonging to alternative therapeutics claimed to be effective in this disease. In homeopathy-a branch of alternative medicine some medicines are claimed to be effective in COVID-19 after human trials. Aim: To study whether ultradiluted preparation of Phosphorus 6CH (centesimal (C) dilutions, using Hanhemann's (H) dilution method) can protect damaging action of Delta Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) spike protein Receptor Binding Domain (RBD) in Gallus gallus embryo in relation to their gross appearances, histopathological changes and cytokine changes. Materials and Methods: An in-vivo fertilized chick embryo model experimental analysis was carried out at the Genetic Research Laboratory of Heritage Institute of Technology, Kolkata, West Bengal, India. The whole experimental study was done in a time period of November 2021 to January 2022 and the data collected were analysed using statistical software Minitab. About 14 days old Gallus gallus embryonated eggs were inoculated with the antigen along with the vehicle alcohol controls. The Phosphorus 6CH was used to see whether it can prevent or cure the damaging action of the spike protein in the embryo in different experimental sets. results: The notable finding in this experiment is the remarkable elevated expression of Interleukin (IL)-10 gene in the curative, preventive sets as well as in the medicine control sets in comparison to antigen and alcohol control sets. In case of Transforming Growth Factor, (TGF) β1 there was enhanced expression of TGF β1 gene in the alcohol 6C set and antigen set which gets ameliorated with Phosphorus 6CH. The morbid anatomy of the embryo and the histopathological picture of the liver of the embryo also reflected similar findings in these two experimental sets. After statistical analysis it was found that there was significant correlation in between Interferon (IF) γ and IL-10 in these experimental results which appears very important. conclusion: The homeopathic medicine phosphorus 6CH is capable of maintaining cytokine balance in Delta SARS-CoV-2 spike protein RBD induced pathogenecity in Gallus gallus embryo.