Lecture abstract: The COVID-19 pandemic has wreaked havoc on women of reproductive age. Etiologies remain unclear but could include COVID-19 illness, vaccine, lipid nanoparticles, or spike protein shedding. In my lecture, I will focus on the characteristics of reproductive issues in women with spike-induced disease and how these issues can be managed. I will discuss recent research that has found remarkable incidences of decidual cast shedding, stunning increases in menstrual irregularities, and significant increases in adverse events in pregnancy.