Could the Angiotensin converting enzyme 2 in Corona pandemic affect female infertility? review article

Recently in 2019, a novel virus from coronavirus family (Sars-CoV-2) was introduced in China. ACE2 is a zinc metalloprotease played role in the angiotensin system. Earliest reports indicate that 2019-nCoV and SARS-CoV tend to cells that express ACE2 on their surface. ACE2 is widely expressed in various organs such as the ovaries and other tissues of the female reproductive system and therefore can help Sars-CoV-2 to enter this system. COVID-19 infection can have dangerous effects on pregnant women or even cause infertility and other disorders of the female reproductive system.

In July 2020, we researched on the PubMed and Google Scholar databases. We excluded articles that had an unrelated title or abstract. Finally, we selected the studies that were most relevant to our research subject.

ACE2 facilitates the attachment of the corona virus to the host cell membrane. As a result, the virus will enter the genome of the target cell. ACE2 has been shown to be expressed in various organs of the female reproductive system, and therefore SARS-CoV-2 can enter these cells. Studies to date have shown an invasion of new coronavirus into granulosa cells and ovarian tissue, endometrial epithelial cells, vagina, uterus and placenta.

SARS-CoV-2 has the potential to impair female fertility. With the assist of ACE2, the virus invades the female genital tissues, can affect the process of steroidogenesis, folliculogenesis and ovulation, and may eventually lead to menstrual irregularities, miscarriages and even infertility. To date, there have been no reports of coronavirus in the female reproductive system. At present, there is no evidence that the SARS-CoV-2 virus uses ACE2 receptors in the reproductive system or how they affect oocyte quality, ensuing pregnancy, or fetal growth.