Viral Infection of the Reproductive System in Times of COVID-19

Abstract

Coronavirus (SARS-COV2) caused several deaths worldwide. This virus infects the target cell by binding to angiotensin-converting enzymes 2 (ACE2) receptor through its receptor-binding domain (RBD) and replicates. Thus, a high level of ACE2 expression is detected in the testicular cells so that the testis is believed to count as a potential target for direct damage by COVID-19. Moreover, the possibility of testicular damage may be caused by either direct viral invasion through interaction with ACE2 receptors or because of inflammatory response. Similarly, in women, literature reported the distribution and function of ACE2 in the female reproductive system, which is widely expressed in the ovary, uterus, vagina, and placenta. It regulates follicular development and ovulation, modulates luteal angiogenesis and degeneration, and influences regular changes in endometrial tissue and embryo development. Taking these functions into account, COVID-19 may disturb the female reproductive functions through regulating ACE2, resulting in infertility, menstrual disorder, and fetal distress.