Background
Viral detection in seminal fluid indicates their potential for both sexual transmission and impairment of reproductive health. Review of the mechanistic entry, sexual transmission and viral impacts for patients during major recent viral outbreaks of Zika virus (ZIKV), Ebola virus (EBOV), severe acute respiratory syndrome (SARS)-coronavirus (CoV), and SARS-coronavirus 2 (CoV-2) (the virus which causes COVID-19) provides a framework to discuss this potential.
Aim
Comparative analysis of prior viral presence on seminal fluid against current (preliminary) findings for SARS-CoV-2 to predict biological implications of the novel coronavirus upon current sexual transmissibility, viral presence, and reproductive health.
Methodology and findings
Literature review was conducted using PubMed and Google Scholar databases. ZIKV and EBOV were found to be present in semen and to be sexually transmitted, leading the World Health Organization (WHO) to update their guidelines on prevention of the two viruses to include refraining from sexual contact. There are conflicting studies regarding the presence of SARS-CoV in male reproductive tissue, but it has been linked to testicular atrophy and orchitis. To date, two studies have detected SARS-CoV-2 RNA in semen, while seven studies have reported no positive detection.
Conclusions
Though unlikely in the majority of cases, SARS-CoV-2 can potentially be present in seminal fluid, although there are no reports of sexual transmission to date. Prior epidemics raise significant concerns regarding the long-term reproductive health capacity for patients who are affected by entry of Sars-CoV-2 into the reproductive tract, therefore more study is needed to clarify the impacts to reproductive health.
About 50% of infertility cases involve male factors (Winters & Walsh, 2014). Over the past several decades, there has been a reported decline in sperm count worldwide (Levine et al., 2017;Sengupta et al., 2018). The current leading diagnosis for male infertility is thought to be idiopathic, with falling sperm counts and semen quality thought to stem from factors such as obesity, illicit substance use, smoking, excessive alcohol use or environmental toxin exposure (Barazani et al., 2014;Krzastek et al., 2020). Furthermore, many different explanatory hypotheses have been developed delineating potential mechanisms contributing to male-factor infertility, including
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