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Minerva Obstetrics and Gynecology 2021 Jun 17

DOI: 10.23736/S2724-606X.21.04870-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The negative impact of most relevant infections on fertility and Assisted Reproduction Technology

Luigi CARBONE 1 , Alessandro CONFORTI 1, Antonio LA MARCA 2, Federica CARIATI 3, Roberta VALLONE 1, Antonio RAFFONE 1, Cira BUONFANTINO 4, Michela PALESE 1, Marika MASCIA 1, Raffaella DI GIROLAMO 5, Martina CAPUZZO 2, Sandro C. ESTEVES 6, 7, 8, Carlo ALVIGGI 1

1 Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy; 2 Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy; 3 CEINGE-Biotecnologie Avanzate scarl, Naples, Italy; 4 Department of Public Health, University of Naples Federico II, Naples, Italy; 5 Center for High-Risk Pregnancy and Fetal Care, Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy; 6 Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP, Brazil; 7 Faculty of Health, Aarhus University, Aarhus, Denmark; 8 ANDROFERT, Andrology and Human Reproduction Clinic, Nossa Sra. Auxiliadora, Campinas, SP, Brazil


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Infections may act with variable impact on the physiopathology of the reproductive organs, determining infertility or reducing the outcomes of assisted reproduction technology. The aim of this narrative review is to describe the existing evidence regarding the pathogens with a supposed or recognized role in reproductive medicine. Viral hepatitis, as HIV, can reduce sperm quality. Syphilis carries a risk of erectile dysfunction and increased endometrial thickness. Chlamydia is the main cause of pelvic inflammatory disease. In relation to Mycoplasma and Ureaplasma spp., only few species seem to show a correlation with infertility and poor in-vitro fertilization outcomes. There is evidence of a role for bacterial vaginosis in early pregnancy loss. HPV infection in males seems to determine infertility. Herpesviruses are more a risk for fetuses than for fertility itself. Zika virus is responsible for altered early embryo development and waiting to conceive is recommended in suspected or confirmed cases. The impact of SARS-CoV-2 is yet to be elucidated. Rubella and toxoplasmosis can provoke important congenital defects and therefore screening is mandatory before conception; a vaccine for Rubella is recommended. Further and well-designed studies are still needed to better elucidate the role of some infectious agents, to improve fertility and its treatments.


KEY WORDS: Assisted Reproduction Technology (ART); Bacterial vaginosis; Covid-19; In-vitro-fertilization (IVF); Sexually transmitted disease; Zika virus; SARS-COV-2

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