How the COVID-19 Pandemic may be Affecting your Fertility

How the COVID-19 Pandemic may be Affecting your Fertility

COVID-19, declared by the World Health Organization as a pandemic on March 11th, 2020, needs no introduction by now. The SARS-CoV-2, being a respiratory virus, mainly affects the lungs, but is capable of infecting other vital organs including the brain, heart, and kidneys. Additionally, emerging research suggests the virus may have implications for fertility.

Given that the human ACE 2 (Angiotensin Converting Enzyme-2) receptor is important for viral spread to host cells and that ACE 2 is also found on the male reproductive organ, attention has been given to the study of the effect of COVID-19 on sperm production and male fertility. Furthermore, Canada’s fertility rate hit a record low in 2019 and is expected to change as a result of the pandemic.

 There are frequent claims that the pandemic will result in a “baby boom”. It is argued that couples spend more time with each other and, as such, are more likely to procreate. However, the scientific evidence for this is sparse. Nevertheless, how the COVID-19 pandemic affects fertility has implications for the rate of population aging, shaping future health challenges and economic growth potential across the world.

Although the physiological basis of COVID-19 on infertility is under study, it is important to note that the implications of COVID-19 on infertility are also tied to interpersonal relationships as well as social policies and practices.

 Women’s Mental Health Disparities

If previous epidemics have been a reflection of how women’s health needs have been largely neglected, causing great mental and physical anguish, COVID-19 too has a part in the health disparities that women face.

The previous outbreaks of Ebola and Zika virus have witnessed spikes in domestic violence and gender bias. Similarly, during the COVID-19, global societies witnessed increased discrimination and acts of violence against women, namely women with an Asian heritage.

Furthermore, increased acts of domestic violence can be attributed to the day-long stay and failure to escape abusive partners, social isolation, the absence of coordination between social and judicial services, and lack of supportive care for crisis management.4 Sadly, there have been reports of sexual exploitation of women by landlords for cheaper accommodation.

A national shelter survey in Scotland reported 22,000 women confirming this fact, as well as other reports from Hawaii and the US. In honor of mental awareness month, it’s appropriate to acknowledge and work against the gender bias that serves to produce mental health disparities for women.

Pregnancy during the COVID-19 Pandemic

Pregnant women and nursing mothers, a historical population of interest, are also a popular topic of research due to the potential transmission of COVID-19 to infants and its role in healthy child development.

The current evidence is limited; however, the majority of studies suggest that there is no mother-to-child transmission of COVID-19 and there is no abnormal child development in asymptomatic or mildly infected mothers.4 Nevertheless, pregnant women with suspected COVID-19 infection should be monitored with a 2-4 weekly ultrasound assessment of fetal growth and amniotic fluid volume.4 Nursing and breastfeeding mothers with a COVID-19 infection should take precautions and respiratory hygiene should be practiced.

As for women who are planning on conceiving, research suggests that it would be advisable to defer pregnancy till we have a clearer insight on the effect of pregnancy. In fact, part of the drop in the fertility rates may be explainable by this factor. A post-pandemic directive has put a pause on elective procedures to alleviate strain on the already overwhelmed hospitals.

This has subsequently limited the work done by fertility and abortion clinics and has hindered women’s access to contraceptives, more notably by adolescents and younger adults. Understandably, this is anxiety-provoking for many women and may be considered a violation of their reproductive rights. As of May 19^th, 2020, at least 11 states in the US had exploited the pandemic to ban or restrict access to abortion.

Fortunately, Canada has declared abortions an essential service amidst the COVID-19 pandemic, though health care is under provincial and territorial jurisdiction, meaning that the extent to which surgeries and procedures are canceled vary across Canada. This example highlights the effect of social policies on moderating the adverse effect of the COVID-19 pandemic on women’s reproductive rights and fertility.

May is the mental awareness month and as such it is the duty of good citizens to acknowledge the mental health disparities that marginalized populations such as women face during the COVID-19 pandemic and work as a society to transcend these barriers, thereby promoting mental health equality that goes hand in hand with celebrating women’s reproductive rights.

Author: Parsa Nafari, Bachelor of Science, Kinesiology 

Reviewed by: Dr. Pari Saharkhiz, M.D.  

Sources:

1. Anifandis, G., Tempest, H. G., Oliva, R., Swanson, G. M., Simopoulou, M., Easley, C. A., . . . Krawetz, S. A. (2021). COVID-19 and Human reproduction: A pandemic that packs a serious punch. Systems Biology in Reproductive Medicine, 67(1), 3-23. doi:10.1080/19396368.2020.1855271
2. Government of Canada, S. (2020, November 23). Births, 2019. Retrieved May 08, 2021, from https://www150.statcan.gc.ca/n1/daily-quotidien/200929/dq200929e-eng.htm
3. Aassve, A., Cavalli, N., Mencarini, L., Plach, S., & Livi Bacci, M. (2020). The COVID-19 pandemic and human fertility.Science, 369(6502), 370-371. doi:10.1126/science.abc9520
4. Singh, N., Sharma, P., & Sharma, S. (2020). COVID-19: Endangering WOMEN'S mental and reproductive health.Indian Journal of Public Health, 64(6), 251. doi:10.4103/ijph.ijph_498_20
5. Murphy, N. (2020, April 11). Landlords 'asking for sex instead of rent' during coronavirus crisis. Retrieved May 08, 2021, from https://www.mirror.co.uk/news/uk-news/landlords-asking-sex-instead-rent-21851062
6. Taylor, B. (2021, April 24). Ontario fertility CLINICS left in limbo AFTER directive to cease non-emergency procedures. Retrieved May 08, 2021, from https://www.ctvnews.ca/health/coronavirus/ontario-fertility-clinics-left-in-limbo-after-directive-to-cease-non-emergency-procedures-1.5400833
7. Lindberg, L. D., Bell, D. L., & Kantor, L. M. (2020). The sexual and reproductive health of adolescents and young adults during the COVID ‐19 PANDEMIC. Perspectives on Sexual and Reproductive Health, 52(2), 75-79. doi:10.1363/psrh.12151
8. Gilmore, R. (2020, March 26). Abortion access will be maintained across Canada amid COVID-19 outbreak. Retrieved May 08, 2021, from https://www.ctvnews.ca/health/coronavirus/abortion-access-will-be-maintained-across-canada-amid-covid-19-outbreak-1.4870129