Coronavirus: A possible cause of reduced male fertility

Abstract

In lately December 2019, a novel coronavirus (SARS‐CoV‐2) outbreak occurred in Wuhan, PR China. It is a high contagious virus that has threatened human health worldwide. SARS‐CoV‐2 infection, termed COVID‐19, causes rapidly developing lung lesions that can lead to multiple organ failure in a short period. Whenever a novel virus emerges, reproductive risk assessments should be performed after infection. In this review, we show that male fertility might be damaged by coronavirus associated with (i) direct cytopathic effects derived from viral replication and viral dissemination in the testis; and (ii) indirect damage to male fertility derived from immunopathology. In this review, we briefly describe the impaired fertility of humans and animals infected with coronaviruses to deduce the impact of the new coronavirus on male fertility. Together with information related to other coronaviruses, we extrapolate this knowledge to the new coronavirus SARS‐CoV‐2, which may have a significant impact on our understanding of the pathophysiology of this new virus.

Potential effects of COVID-19 on reproductive systems and fertility; assisted reproductive technology guidelines and considerations: a review

“…17,23,24 Male patients with COVID-19 and high immunoglobulin G titre might also have adverse reproductive effects, possibly caused by anti-sperm antibodies such as antiphospholipid antibodies, which interfere with fertilisation. 25 Inflammatory infiltration may disrupt spermatogenesis, impede steroidogenesis, and destroy cells in seminiferous tubules. 26 Moreover, SAR-CoV-2 induces oxidative stress via inflammatory responses, which might disrupt the process of spermiogenesis and lead to spermatozoa having poorly remodelled chromatin.…”

Is Male Reproductive System More Vulnerable to SARS-CoV-2 Than Female’s?

“…This evidence leads to the hypothesis that semen could not be a route of SARSCoV-2 transmission and there is low risk of viral transmission through assisted reproductive techniques (ARTs) during COVID-19 outbreak. Eventually, severe destruction of the testicular tissue is quite evident in histopathological examinations despite the above finding ( 1 , 4 ).…”

“…It has also been shown that high levels of IL-6 disrupt the integrity of BTB, which facilitates virus infiltration and probably direct damages to spermatogenic cells. In fact, this may be the reason for the various reports on orchitis-like syndrome in COVID-19 patients ( 1 , 5 ).…”

“…ACE2 was known to be expressed in more than 30 organs, such as the kidneys, testes, heart, gallbladder, small intestine, colon, thyroid, and adipose tissue, etc . which are potentially targets of SARS-CoV-2 and may be the cause of several organ failures following COVID-19 infection ( 1 ).…”

“…Immunohistochemical examination on slides of testicular tissue of dead men from COVID-19 showed orchitis-like syndrome with a large amount of IgG deposition in the seminiferous epithelium and also destroyed spermatogenic and Sertoli cells. This may be a key factor for secondary autoimmune response to SARS-CoV-2 virus, thereby leading to exacerbation of testicular damage with autoimmune orchitis ( 1 ).…”