Two mRNA vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), received Emergency Use Authorization from the US Food and Drug Administration. Despite high efficacy and few adverse events found in clinical trials, only 56% of individuals in the US reported wanting to receive the vaccine. 1 One of the reasons for vaccine hesitancy is the potential negative effect on fertility. 2 Because reproductive toxicity was not evaluated in the clinical trials and SARS-CoV-2 has been associated with decreases in sperm parameters, 3 we assessed sperm parameters before and after mRNA vaccine administration.

is a cofounder of Gritstone Oncology and holds equity in An2H. Timothy A. Chan serves as an advisor for Bristol-Myers Squibb, Illumina and AstraZeneca. Timothy A. Chan receives research support from AstraZeneca and Illumina. Timothy A. Chan holds a patent for the use of TMB to predict immunotherapy response. This is licensed to PGDx and MSK and Timothy A. Chan are entitled to receive royalties. Vladimir Makarov holds patent rights.

The coronavirus 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to more than 160 million infections and 3.5 million deaths globally. Men are disproportionately affected by COVID-19, having more severe disease with higher mortality rates than women. Androgens have been implicated as the underlying cause for more severe disease, as the androgen receptor has been noted to upregulate the cell surface receptors that mediate viral cell entry and infection. Unfortunately, despite testosterone's potential role in COVID-19 prognosis, androgen deprivation therapy is neither protective nor a treatment for COVID-19. Interestingly, the male reproductive organs have been found to be vulnerable in moderate to severe illness, leading to reports of erectile dysfunction and orchitis. COVID-19 viral particles have been identified in penile and testis tissue, both in live patients who recovered from COVID-19 and post mortem in men who succumbed to the disease. Although sexual transmission remains unlikely in recovered men, moderate to severe COVID-19 infection can lead to germ cell and Leydig cell depletion, leading to decreased spermatogenesis and male hypogonadism. The objective of this review is to describe the impact of SARS-CoV-2 on male reproductive health. There are still many unanswered questions as to the specific underlying mechanisms by which COVID-19 impacts male reproductive organs and the long-term sequelae of SARS-CoV-2 on male reproductive health.

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