Does "yangkang" affect sperm and ovarian function? How to prepare for pregnancy after "yangkang"?

Recently, nearly 80% of the patients attending the Reproductive Immunology Clinic at Guangdong Reproductive Hospital were "positive" - infected with the New Coronavirus. For many sisters who are preparing for pregnancy, especially mothers who have suffered recurrent miscarriages, contracting the neo-coronavirus can be a real challenge. To address some of the nagging questions about pregnancy preparation and pregnancy, the director of the reproductive immunology department of Guangdong Provincial Reproductive Hospital, Zhong Xingming, provides detailed answers!

Will the ovarian function be affected after the "positive pass"?

Zhong Xingming: The data from some small studies show that there is no difference in AMH levels before and after women are infected with SARS-CoV-2 (the virus that causes COVID-19). Data from domestic studies also show no significant changes in mean sex hormone levels and ovarian reserve function indicators in women of childbearing age with new crown infection; some women experience changes in menstrual cycle and volume, which can also be quickly restored after recovery from infection. These results suggest that there is no significant impact on ovarian function in women of childbearing age, and there is no need to worry about fewer eggs after "yangkang".

 When can I start preparing for pregnancy after "yangkang"?

Zhong Xingming: There are no strong evidence-based medical guidelines to guide the timing of pregnancy preparation. There are some existing studies that we can use as a reference. For men, some studies have found that total sperm count, sperm concentration, total motile sperm count and forward-moving sperm count are temporarily reduced after COVID-19 infection. However, there is no reliable evidence that the new coronavirus itself causes testicular damage. For the female partner, available studies have not yet shown a negative impact of neo-coronavirus infection on female ovarian function and assisted reproductive outcomes.

For asymptomatic and mildly ill patients, you can start preparing for pregnancy after a period following "Yang Kang". Of course, if you are really unsure and are not in a hurry to prepare for pregnancy, you can wait for three months.

For patients with more severe infections, you should wait until your body recovers before considering pregnancy preparation.

In another case, if you suddenly "win" the lottery one day after "Yang Kang", you should not be too anxious. Although there are no studies on this, if you are planning to conceive, you can monitor the embryo development regularly after pregnancy.

Does being positive during pregnancy have any effect?

Zhong Xingming: Current international studies show that the probability of intrauterine transmission of the new coronavirus is extremely low, and there is not enough evidence that the new coronavirus can infect the fetus through the placenta. It is not advisable to blindly adopt a one-size-fits-all "termination of pregnancy" protocol for patients with novel coronavirus infection during pregnancy. The risk of neocoronavirus infection in pregnancy is the same as in the general population, but infected pregnant women, especially those with pneumonia and/or myocarditis, may have an increased incidence of preterm labor and cesarean delivery. Therefore, obstetric examinations need to be intensified during pregnancy, unless the infection seriously affects the safety of mother and fetus, and the doctor will decide whether to continue the pregnancy.

What should be noted for patients with a history of recurrent miscarriage who are on birth control?

Zhong Xingming: Pregnant women with a history of recurrent miscarriage need to be treated with fetal preservation drugs for the cause of miscarriage. Usually, progesterone (progestin) and drugs for hyperthyroidism, hypothyroidism, diabetes such as eugenol, propylthiouracil, insulin, etc. taken for endocrine factors do not conflict with drugs for the treatment of neonatal coronary, such as acetaminophen and acetylcysteine for coughing; for patients with combined embolism, the use of aspirin and heparin is not affected, but it is recommended that the time interval between them and drugs for the treatment of neonatal coronary should be more than 2 hours. For patients with combined autoimmune diseases, hydroxychloroquine and small doses of prednisone (5-10mg/day) can be used routinely and regularly. (Tip: All kinds of immunosuppressants need to be used under the premise of clear indications, avoid high doses, long-term, super-indications to avoid adverse effects.)

3 How to prepare for pregnancy in patients who are preparing for pregnancy?

Zhong Xingming: Refer to the "General Precautions" in the "Novel Coronavirus Pneumonia Treatment Protocol (Trial Version 9)": maintain good personal and environmental hygiene, balanced nutrition, moderate exercise, adequate rest, and avoid overexertion. Before preparing for pregnancy, the necessary pre-pregnancy medical examination should be carried out; folic acid should be taken regularly; and the new crown vaccination should be given in a timely manner.

In conclusion, from the available data, "Yang Kang" will not affect human reproductive capacity; infection with New Guan during pregnancy will not lead to an increased risk of fetal abortion and will not increase the risk of birth defects; if there is no related underlying disease, the risk of serious illness in pregnant women will not increase significantly.

In 2023, the epidemic is uncertain, but for sisters who are preparing for pregnancy, the desire to have children is certain. Be prepared to live with the new coronavirus for a long time, take personal protection, live your life well, prepare for pregnancy if you should, get pregnant if you should, and wish you all a good pregnancy in 2023!