The Effects of SARS-CoV-2 Infection on Female Fertility: A Review of the Literature

As the coronavirus pandemic is far from ending, more questions regarding the female reproductive system, particularly fertility issues, arise. The purpose of this paper is to bring light upon the possible link between COVID-19 and women’s reproductive health. This review emphasizes the effect of SARS-CoV-2 on the hormones, endometrium and menstrual cycle, ovarian reserve, follicular fluid, oocytes, and embryos. The results showed that endometrial samples did not express SARS-CoV-2 RNA. Regarding the menstrual cycle, there is a large range of alterations, but they were all reversible within the following months. The ovarian reserve was not significantly affected in patients recovering from both mild and severe infection in most cases, except one, where the levels of AMH were significantly lower and basal follicle-stimulating hormone (FSH) levels were increased. All COVID-19 recovered patients had positive levels of SARS-CoV-2 IgG in the follicular fluid. The amount of retrieved and mature oocytes and the fertilization rate were unharmed in three studies, except for one study, where the quantity of retrieved and mature oocytes was reduced in patients with higher levels of SARS-CoV-2 antibodies. The numbers of blastocysts, top-quality embryos, and euploid embryos were affected in most of the studies reviewed.

Non-hormonal therapy of patients with fibrocystic mastopathy in combination with endometrial hyperplasia

Introduction. The article presents a comparative analysis of the treatment of patients with combined estrogen-dependent pathology of female reproductive system: fibrocystic mastopathy and endometrial hyperplasia without atypia. The experience of treatment with an indole-carbinol-containing drug as monotherapy while using a levonorgestrel-releasing intrauterine system is presented.Aim. To evaluate the clinical efficacy of indolecarbinol in the treatment of patients with combined estrogen-dependent pathology of the female reproductive system.Materials and methods. The authors studied the responses to the treatment of patients with fibrocystic mastopathy and simple endometrial hyperplasia (n = 65) with the indole-carbinol-containing drug at a dose of 400 mg once daily for 12 months. All patients were divided into two groups: Group I (n = 32) – women who refused hormone therapy (indole-carbinol monotherapy); Group II (n = 33) – the use of indole-carbinol while using the levonorgestrel-releasing intrauterine system. Diagnostic methods: clinical and laboratory examination, ultrasound examination of mammary glands and pelvic organs, mammography, nipple discharge cytology at baseline and 6 and 12 months after the start of therapy. Before study group assignment to treatment, all patients underwent hysteroscopy with endometrial biopsy and histological examination. Descriptive statistics were used to evaluate the data: p-values below 0.05 were considered statistically significant.Results and discussion. The presented experience in treating women with combined pathology of the female reproductive system (fibrocystic mastopathy and endometrial hyperplasia without atypia) with the indole-carbinol-containing drug showed high clinical efficacy in mastopathy (relief of mastodynia (83.0 ± 1.6%), improvement of the ultrasound view of BI-RADS (66.1 ± 1.4%), reductions in mammographic density (66.1 ± 2.1%, p < 0.05)), high tolerability and satisfactory compliance. This drug combined with hormone therapy is recommended for the treatment of endometrial hyperplasia.Сonclusion. The use of indole-carbinol in the treatment of benign hyperplastic processes in mammary glands and endometrial hyperplasia is pathogenetically substantiated and shows high clinical efficacy

Viral Infection of the Reproductive System in Times of COVID-19

Coronavirus (SARS-COV2) caused several deaths worldwide. This virus infects the target cell by binding to angiotensin-converting enzymes 2 (ACE2) receptor through its receptor-binding domain (RBD) and replicates. Thus, a high level of ACE2 expression is detected in the testicular cells so that the testis is believed to count as a potential target for direct damage by COVID-19. Moreover, the possibility of testicular damage may be caused by either direct viral invasion through interaction with ACE2 receptors or because of inflammatory response. Similarly, in women, literature reported the distribution and function of ACE2 in the female reproductive system, which is widely expressed in the ovary, uterus, vagina, and placenta. It regulates follicular development and ovulation, modulates luteal angiogenesis and degeneration, and influences regular changes in endometrial tissue and embryo development. Taking these functions into account, COVID-19 may disturb the female reproductive functions through regulating ACE2, resulting in infertility, menstrual disorder, and fetal distress.

A Case Study on Ayurvedic Management in PCOS

Female reproductive system consists of hypothalamo-pituitary-ovarian axis and intact uterine-adnexa which maintains a complex mechanism. In human body all the systems are interrelated to function properly; any imbalance in one system may cause multisystem pathogenesis. Polycystic ovarian syndrome (PCOS) is a common endocrinopathy, which is multifactorial and polygenic condition, manifested as oligoovulation or anovulation, signs of hyperandrogenism and multiple small ovarian cysts. Signs and symptoms vary within individual’s overtime. This adversely affect the reproductive system by menstrual disorders, infertility, obesity, depression, sleep apnea, insulin resistance and in due course may result in diabetes mellitus, endometrial cancer, cardiovascular disease etc. According to Ayurveda PCOS is a disorder which involves the three Doshas, Dhathus like Rasa, Raktha and Medas. The Srothas involved in this condition are Rasa, Rakta and Arthava vaha which eventually manifests features such as Anarthava (amenorrhea), Vandhyathwa, Pushpagni, Abeeja rtuchakra (anovular bleeding). Here is a case report of 19 year old girl who presented with irregular menstruation, rapid weight gain and hair loss. On USG she was detected to have bilateral PCO pattern. Based on the clinical features, treatment principles adopted were Aamapachana, Vata anulomana, Kaphapittahara and Arthava janana. After 2 months of internal medications, symptoms reduced markedly and menstruation was normal. Adherence to Ayurvedic principles is found to be helpful in PCOS for a healthy and fruitful life.

Ovary Structure and Oogenesis of Trypophloeus klimeschi (Coleoptera: Curculionidae: Scolytinae)

The female reproductive system, ovary structure and ultrastructure of Trypophloeus klimeschi (Coleoptera: Curculionidae: Scolytinae) were investigated using light microscopy, scanning electron microscopy, and transmission electron microscopy. Its female reproductive system is comprised of two ovaries (each ovary has two ovarioles), lateral oviducts, common oviduct, spermathecal sac, spermathecal pump, two accessory glands and bursa copulatrix. Well-developed endoplasmic reticulum can be clearly seen in the secretory cells of spermathecal sac. This species has telotrophic meroistic ovarioles that are comprised of terminal filament, tropharium, vitellarium and pedicel. The terminal filaments are simple; each is comprised of cellular peritoneal sheath. The presence of several clusters of nurse cells in the tropharium is indicative that its ovarioles conform to the transition stage. This indicates that there are at least two different types (transition stage and secondary stage) of ovarioles in Curculionidae.

ETV5-mediated upregulation of lncRNA CTBP1-DT as a ceRNA facilitates HGSOC progression by regulating miR-188-5p/MAP3K3 axis

High-grade serous ovarian cancer (HGSOC) is a common and lethal cancer of the female reproductive system. Long non-coding RNAs (lncRNAs) are aberrantly expressed in various cancers and play crucial roles in tumour progression. However, their function and molecular mechanism in HGSOC remain largely unknown. Based on public databases and bioinformatics analyses, the overexpression of lncRNA CTBP1-DT in HGSOC tissues was detected and validated in a cohort of HGSOC tissues. High expression of lncRNA CTBP1-DT was associated with poor prognosis and was an independent risk factor for survival. Overexpression of lncRNA CTBP1-DT promoted malignant biological behaviour of HGSOC cells, whereas its depletion induced growth arrest of HGSOC cells by vitro and in vivo assays. Mechanistically, lncRNA CTBP1-DT could competitively bind to miR-188-5p to protect MAP3K3 from degradation. Moreover, our results revealed that ETV5 could specifically interact with the promoter of lncRNA CTBP1-DT and activate its transcription. Collectively, these results reveal a novel ETV5/lncRNA CTBP1-DT/miR-188-5p/MAP3K3 pathway for HGSOC progression and suggest that lncRNA CTBP1-DT might be a potential biomarker and therapeutic target for HGSOC.