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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2022; 82(05): 490-500
DOI: 10.1055/a-1750-9284
DOI: 10.1055/a-1750-9284
GebFra Science
Review/Übersicht
„Corona und Reproduktion“ oder warum die Coronaimpfung nicht unfruchtbar macht
Article in several languages: English | deutsch
Zusammenfassung
Hintergrund Mit Fortschreiten der COVID-19-Pandemie und der Entwicklung neuer Impfstoffe wächst in der Öffentlichkeit die Sorge, dass sowohl eine Infektion mit dem SARS-CoV-2-Virus als auch eine Coronaimpfung (mRNA-Impfstoffe) zu einer Infertilität bzw. einer erhöhten Abortrate führen könnten. Besonders junge, in der Reproduktionsphase befindliche Menschen äußern diese Ängste. Der vorliegende Übersichtsartikel fasst die aktuellen Daten zum Einfluss einer SARS-CoV-2-Infektion bzw. einer Coronaimpfung auf die weibliche und männliche Fertilität am Tiermodell und auf humaner Seite zusammen.
Methoden Anhand der Schlüsselwörter „COVID 19, SARS-CoV-2, fertility, semen, sperm, oocyte, male fertility, female fertility, infertility“ wurde eine systematische Literaturrecherche durchgeführt (Pubmed, Embase, Web of Science). Im Anschluss wurden Originalarbeiten von Oktober 2019 bis Oktober 2021 ausgewählt und aufgearbeitet.
Ergebnisse Im Tiermodell war trotz des Einsatzes von sehr hohen Impfdosen kein negativer Effekt auf die Fruchtbarkeit, den Schwangerschaftsverlauf und die fetale Entwicklung nachweisbar. Auf humaner Seite wurde bei infizierten Frauen keine SARS-CoV-2-RNA in Oozyten/Follikelflüssigkeit nachgewiesen; ebenso zeigten sich zwischen Genesenen, Geimpften und Kontrollen keine Unterschiede hinsichtlich Schwangerschaftshäufigkeit und des Anteils gesunder Kinder. Ferner beeinflusste die Impfung auch nicht die Lebendgeburtenrate nach einer assistierten reproduktionsmedizinischen Behandlung. Bei infizierten und noch infektiösen Männern wurde in der Mehrzahl der Fälle keine Virus-RNA im Ejakulat nachgewiesen; allerdings zeigten sich deutliche Einschränkungen im Spermiogramm, insbesondere nach schwerwiegend verlaufender Infektion. Bisherige Studien zeigen keinen negativen Einfluss einer Coronaimpfung auf die männliche Fertilität.
Diskussion Die aktuellen Studien geben weder im Tiermodell noch auf humaner Seite einen Hinweis auf eine Einschränkung der Fertilität nach einer Coronaimpfung. Demgegenüber gibt es zunehmende Hinweise für negative Auswirkungen einer schweren SARS-CoV-2-Infektion auf die männliche Fertilität und klare Evidenz für ein erhöhtes Komplikationsrisiko von Schwangeren bei einer SARS-CoV-2-Infektion. Die Beratung von jungen Menschen sollte daher sowohl die Ängste und Sorgen ernst nehmen als auch die aktuelle Datenlage strukturiert erörtern.
Schlüsselwörter
COVID-19 - Corona-Impfung - SARS-CoV-2 - Reproduktion - Spermien - Eizellen - Embryo - InfertilitätPublication History
Received: 20 November 2021
Accepted after revision: 25 January 2022
Article published online:
06 May 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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