Effect of COVID-19 on Male Reproductive System – A Systematic Review

BackgroundAngiotensin-converting enzyme II (ACE2), a receptor for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) to enter host cells, is widely expressed in testes and prostate tissues. The testis and prostate produce semen. At present, there are contradictory reports about whether SARS-CoV-2 can exist in the semen of infected men.ObjectiveTo provide a comprehensive overview of the topic of whether COVID-19 can impact on male reproductive system.MethodsWe reviewed the relevant publications on the possible impact of Coronavirus Disease 2019 (COVID-19) on male reproductive system and summarized the latest and most important research results so far. Literature published in English from December 2019 to January 31, 2021 regarding the existence of SARS-CoV-2 in semen, testis, and prostatic fluid and the effects of COVID-19 on male reproductive were included.ResultsWe identified 28 related studies, only one of which reported the presence of SARS-CoV-2 in semen. The study found that the semen quality of patients with moderate infection was lower than that of patients with mild infection and healthy controls. The impaired semen quality may be related to fever and inflammation. Pathological analysis of the testis/epididymis showed that SARS-CoV-2 viral particles were positive in 10 testicular samples, and the spermatogenic function of the testis was impaired. All 94 expressed prostatic secretion (EPS) samples were negative for SARS-CoV-2 RNA.ConclusionThe likelihood of SARS-CoV-2 in the semen of COVID-19 patients is very small, and semen should rarely be regarded as a carrier of SARS-CoV-2 genetic material. However, COVID-19 may cause testicular spermatogenic dysfunction via immune or inflammatory reactions. Long-term follow-up is needed for COVID-19 male patients and fetuses conceived during the father’s infection period.

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O-037 The impact of COVID-19 on male fertility: what do we know?”

Human Reproduction ◽

10.1093/humrep/deab126.036 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

A Pacey

Keyword(s):

Reproductive System ◽

Male Fertility ◽

Semen Quality ◽

Sperm Concentration ◽

Reproductive Hormones ◽

Male Reproductive System ◽

Host Cells ◽

Increased Risk ◽

The Impact

Abstract text Since the very early days of the COVID-19 pandemic, concern has been raised about the possibility of damage to the male reproductive system in those men who are infected with SARS-CoV-2. This was first raised by the early observation (January 2020) that the route of infection was via the Angiotensin Converting Enzyme 2 (ACE-2) receptor present on host cells. ACE-2 was first described in the year 2000 and subsequently shown in 2004 to be selectively expressed in the Leydig cells of the adult testis. This opens up the possibility that although COVID-19 is primarily a respiratory infection, it may also infect the male reproductive system. The authors of several review articles have proposed that male fertility may be theoretically impacted by SARS-CoV-2 in a number of ways. This includes alteration of: (i) testicular architecture; (ii) reproductive hormone profiles (LH/FSH); (iii) spermatogenesis as evidenced by changes to ejaculate quality; (iv) sperm function (e.g., DNA damage); (v) sexual/erectile function; or a combination of all five. Clearly each of these individually may impact on the chance of pregnancy or live birth either in natural or medically assisted reproduction. There is also the possibility that SARS-CoV-2 may be transmitted sexually if sufficient numbers of SARS-CoV-2 are found in semen. Reassuringly, of 14 studies published to date, there is little evidence to suggest that SARS-CoV-2 is present in semen and so the possibility of sexual transmission in patient or donor samples can probably be discounted. However, there is currently an incomplete picture of whether semen quality is affected by SARS-CoV-2 infection as studies are often limited by the fact that no pre-infection control samples are available for direct comparison or they are too short to identify any long-term effects. Nevertheless, the few case-controlled studies published which compare semen quality infected with non-infected (control) individuals suggest that there may be a statistically significant alteration in sperm concentration and motility, although it is not clear whether this is linked to infection by the SARS-CoV-2 virus or simply a consequence of febrile illness and fever (or medication given to combat the infection). There is currently a lack of long-term data on any impact of COVID-19 on male reproductive hormones (although much speculation about the role that testosterone might play in the severity of disease). There are also emerging reports of increased risk of erectile dysfunction in men following SARS-CoV-2. In terms of birth rates, it is simply too early to tell whether these have been affected by the pandemic, given the possibility of lockdown affecting sexual behaviour in fertile couples and IVF clinic closures in infertile couples. In conclusion, although the COVID-19 pandemic has infected over 130 million people worldwide we still know too little about the impact of SARS-CoV-2 on the male reproductive system. Given the incidence of long-COVID, and the asymptomatic nature of the infection for some, it is important to commission and conduct long-term studies which can monitor the reproductive outcomes of young men who have survived a SARS-CoV-2 infection.

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Effects of 2019 Novel Coronavirus on Male Reproductive System: A Retrospective Study

10.20944/preprints202004.0280.v1 ◽

2020 ◽

Author(s):

Jinzhuo Ning ◽

Wei Li ◽

Yuan Ruan ◽

Yuqi Xia ◽

Xiongfei Wu ◽

...

Keyword(s):

Reproductive System ◽

Throat Swab ◽

Demographic Data ◽

Case Series ◽

Male Reproductive System ◽

N Gene ◽

Organ Distribution ◽

Human Protein Atlas ◽

Long Term Follow Up ◽

Novel Coronavirus

A novel and highly pathogenic coronavirus (2019-nCoV)-induced pneumonia spread worldwide in a short time. However, studies on the effects of 2019-nCoV on the male reproductive system are limited. The aim of this study is to describe the clinical characteristics of the male reproductive system of COVID-19 patients and to explore the presence of 2019-nCoV in semen. Retrospective, single-center case series of 112 male patients with confirmed COVID-19 who were admitted to Renmin Hospital of Wuhan University from January 2 to March 7, 2020. Demographic data, symptoms and signs related to the male reproductive system, throat swabs and semen samples were collected and analyzed. 2019-nCoV RNA measured in throat swab and semen samples. The organ distribution of ACE2 mRNA and protein in human tissue on The Human Protein Atlas portal and investigated immunohistochemistry (IHC) images of the testis. The HPA dataset revealed relatively high levels of ACE2 protein and RNA expression in the testis. A total of 3 severe COVID-19 patients (2.7%) presented with orchidoptosis, while no patients experienced other symptoms or signs related to the male reproductive system. The analysis of 2019-nCoV RNA in semen included 17 patients with fertility needs. Among these patients, 9 (52.9%) remained positive for 2019-nCoV according to throat swab analysis, and 8 (47.1%) became negative. In the semen 2019-nCoV analysis, all 17 patients were negative for the N gene and ORF1ab gene. In view of the potential impairment, long-term follow-up for male COVID-19 patients with fertility needs is of great significance.

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The Male Reproductive System and Endocrine Disruptors

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666211004100633 ◽

2021 ◽

Vol 21 ◽

Author(s):

Schiesaro Mauro Giovanni ◽

Amato Anna Maria Letizia ◽

Maneschi Chiara ◽

Sciabica Vincenzo ◽

Pigatto Erika ◽

...

Keyword(s):

Endocrine Disruptors ◽

Reproductive System ◽

Semen Quality ◽

Reproductive Function ◽

In Vitro Models ◽

Male Reproductive System ◽

Future Research ◽

Testicular Dysgenesis Syndrome ◽

Hormonal Milieu

: The male reproductive system is exposed to a great number of chemical substances which can interfere with the normal hormonal milieu and reproductive function; these are called endocrine disruptors (EDs). Despite a growing number of studies evaluating the negative effects of EDs, their production is continuously growing although some of which have been prohibited. The prevalence of poor semen quality, hypospadias, cryptorchidism, and testicular cancer have increased in the last decades, and recently, it has been postulated that these could all be part of a unique syndrome called testicular dysgenesis syndrome. This syndrome could be related to exposure to a number of EDs which cause imbalances in the hormonal milieu and oestrogenic over-exposure during the foetal stage. The same EDs can also impair spermatogenesis in offspring and have epigenetic effects. Although studies on animal and in vitro models have raised concerns, data are conflicting. However, these studies must be considered as the basis for future research to promote male reproductive health.

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