Study Of The Effect Of SARS-Cov-2 Infection On Female Immune,Ovarian Function And Fertility And The Protection Of Ovarian Function

Background: Whether SARS-CoV-2 infection has effects on ovarian function and fertility of women of child-bearing age was not decided yet.Morever,pregnant women are generally more susceptible to viral infection.Although the impact of SARS-CoV-2 in pregnancy remains to be determined,evidence indicates the risk factors for severe COVID-19 are similar in pregnancy to the general population.The immune response to SARS-CoV-2 in women,especially women of childbearing age was reportedly distinct from that of men.while the specific immune response mechanism is still unclear,and the correlation between women’s unique immune response and the impact of their clinical prognosis and reproductive system after infection is not clear.At the same time,the demand for women’s ovarian function and fertility protection was urgent,and the development of new ovarian protectors is imminent.Design: Clinical and laboratory data from 299 women of child-bearing age and 20 pregnant women diagnosed with COVID-19 were retrospectively reviewed first.Menstrual data from177 patients were analyzed.Blood samples from 91 patients at the early follicular phase were tested for sex hormones and Anti-mullerian hormone(AMH).The obstetric and neonatal outcomes were investigated.Then,we systemically analyzed dynamic changes of laboratory indexes of 20 pregnant and 299 non-pregnant female COVID-19 patients.we applied singlecell m RNA sequencing to profile peripheral blood mononuclear cells from 4 pregnant and 6non-pregnant female patients in their convalescent phase,along with 4 pregnant and 3 nonpregnant healthy donors.For the development of ovarian protectant,we designed GDF9 targeting inhibitory peptides by simulating the spatial structure and binding sites of GDF9 and BMP15.The potential protective peptides were preliminarily identified by in vitro recombinant protein screening,affinity screening,functional screening and safety tests.Results: Among 177 patients with menstrual records,45(25%)patients presented with menstrual volume changes,and 50(28%)patients had menstrual cycle changes,mainly a decreased volume(21%)and a prolonged cycle(19%).The average sex hormone and AMH levels of women of child-bearing age with COVID-19 were not different from those of agematched controls,and the there was no significant difference in the pregnancy outcome between pregnant COVID-19 patients and healthy pregnant women.Pregnant patients showed significant inflammatory response on admission,while less severe cases were found in pregnant patients than in non-pregnant patients.Conclusions: COVID-19 has no significant effect on ovarian function and fertility in women of childbearing age.