Covid-19'un İnfertiliteye Etkisi

Abstract

İnfertilite, dünya nüfusunun yaklaşık %8-12'sini etkileyen yaygın bir sağlık sorunudur. Bu oranları dünyanın çeşitli bölgelerinde büyük farklılıklar göstermekte, doğrudan ve dolaylı faktörlerin doğurganlığı olumsuz etkilediği bilinmektedir. Toksik maddelere maruz kalma, yetersiz beslenme, psikolojik stres ve viral enfeksiyonlar üreme sağlığını etkilediği bilinen faktörlerden olarak sayılabilmektedir. Coronavirus hastalığı-19 (COVID-19) küresel bir sağlık sorunudur. Bu hastalığın üreme sağlığı üzerindeki etkilerini gösteren epidemiyolojik raporlar çeşitli olumsuz etkileri olduğunu bildirilmiştir. Literatürde, COVID-19 tanısı almış 37 yaşındaki bir erkekte bilateral orsiepididimit oluşumu tespit edilmiştir. COVID-19 enfeksiyonu tanısı almış olan bir pediatrik hastada ise orsiepididimit ile ilişkili inflamasyon belirlenmiş ve hastalarda sperm kalitesinde bozulma saptanmıştır. Ayrıca testis hücrelerinde artan bağışıklık tepkisinin spermatogenez sürecini olumsuz etkileyebileceği öne sürülmektedir. Üreme çağındaki kadınlarda da COVID-19 ile enfekte olduklarında menstrual siklus kanama hacminde azalma ve siklus süresinde uzama tespit edilmiştir. Bu sonuçların gelecekte doğurganlık için zararlı olabileceği düşünülmektedir. Geçmişte koronavirüs bulaşmış gebeler arasında spontan düşük ve erken doğum insidanslarının arttığı bildirilmiştir. Sistematik inceleme ve meta-analiz çalışmalarında, COVID-19 hastalarında gebelik sırasında anne ölümü riskinin arttığı ve virüs partikülünün enfekte anneden yenidoğana dikey geçişi yaptığı da belgelenmiştir. Bu nedenle COVID-19 enfeksiyonunun kadın ve erkek üreme sağlığı üzerinde olumsuz etkilerinin olabileceği düşünülmektedir. İnfertilite kliniklerinde çalışan ebelerin bu konuda bilinçlenmesi, danışmalık ve bakım rollerini kullanmada etkili olacaktır. Bu çalışma COVID-19’un üreme sağlığı üzerine etkisini belirlemek amacıyla yazılmıştır.

Keywords

• Covit-19
• infertilite
• doğurganlık

THE EFFECT OF COVID-19 ON INFERTILITY

Abstract

Infertility is a common health problem affecting approximately 8-12% of the world's population. These rates vary greatly in various regions of the world, and it is known that direct and indirect factors negatively affect fertility. Exposure to toxic substances, malnutrition, psychological stress and viral infections can be counted as factors known to affect reproductive health. Coronavirus disease-19 (COVID-19) is a global health problem. Epidemiological reports showing the effects of this disease on reproductive health have reported various adverse effects. In the literature, bilateral orciepididymitis was detected in a 37-year-old man diagnosed with COVID-19. In a pediatric patient who was diagnosed with COVID-19 infection, inflammation associated with orciepididymitis was detected and deterioration in sperm quality was found in the patients. It is also suggested that the increased immune response in testicular cells may adversely affect the spermatogenesis process. When women of reproductive age are infected with COVID-19, a decrease in menstrual cycle bleeding volume and a prolongation of the cycle duration have been detected. It is thought that these results may be detrimental to fertility in the future. It has been reported in the past that the incidence of spontaneous abortion and preterm birth has increased among pregnant women infected with coronavirus. In systematic review and meta-analysis studies, it has also been documented that the risk of maternal death during pregnancy is increased in COVID-19 patients and vertical transmission of the virus particle from the infected mother to the newborn. For this reason, it is thought that COVID-19 infection may have negative effects on reproductive health of women and men. Awareness of midwives working in infertility clinics on this issue will be effective in using their counseling and care roles. This study was written to determine the effect of COVID-19 on reproductive health

Keywords

• COVID-19
• infertility
• fertility

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