COVID-19 and andrology: Recommendations of the French-speaking society of andrology (Société d’Andrologie de langue Française SALF)

Abstract

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) metamorphosed our medical practice. In early June 2020, more than 6,400,000 COVID-19 (coronavirus-19 disease) cases were diagnosed across the world and more than 380,000 deaths were linked to COVID-19. Many medical symptoms of COVID-19 were reported. We will focus, here, on potential impacts of COVID-19 on men's andrological health. Our society (French-speaking society of andrology, SALF) also emitted some recommendations in the andrological management of men infected by SARS-CoV-2. First, considering the fever and the potential presence of SARS-CoV2 in semen, SALF recommends waiting for 3 months (duration of one spermatogenesis cycle and epididymal transit) before restarting ART in the case of men diagnosed COVID-19 positive. Whatever the nature of testosterone and COVID-19 relationships, we recommend an andrological examination, sperm parameters, and hormonal evaluation at the time of the COVID-19 is diagnosed, and several months later. Furthermore, we are concerned by the potential morbid-mortality of the COVID-19, which mainly affects men. This "andrological bias", if proven, must be reduced by specific andrological diagnosis, therapeutic and prophylactic measures. Research in this direction must be substantiated and financially supported over the next few months (years).

Crosstalk between SARS-CoV-2 and Testicular Hemostasis: Perspective View

“…Ahmed Division of Anatomy and Embryology, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt *Address all correspondence to: ahmedragab08@gmail.com including intrauterine inseminations (IUIs) or in vitro fertilization (IVF) during the COVID-19 pandemic [79], particularly, for patients who have immunocompromised diseases (AIDS, cancer, or malnutrition) or chronic diseases (cardiovascular, hepatic, or renal diseases, hypertension, and diabetes mellitus) [80,81]. Similarly, the French Biomedicine Agency (ABM) suspended ART during this period [82]. Finally, the social contact between ART professional groups and patients should be online during this period.…”

COVID‐19 in men: With or without virus in semen, spermatogenesis may be impaired

“…The SARS-CoV-2 virus uses angiotensin-converting enzyme 2 (ACE2) receptors to enter human cells, and the spike protein (protein S) is primed by transmembrane serine protease (TMPRSS2). The male reproductive system is believed to express both the ACE2 and TMPRSS2 receptor in the testes (spermatogonia, Sertoli and Leydig cells) and in prostate epithelial cells (for a review, see Hamdi et al, 2020;Vishvkarma R, & Rajender S, 2020). If receptors for the virus are present at different stages of the male reproductive system, it is not unreasonable to think that the virus could be found in semen either by alteration of the blood-testis barrier but also by excretion into prostatic fluid.…”

“…In infertile men with altered sperm parameters in the basal state, this fever could have a more deleterious impact. For this reason, it has recently been recommended to monitor sperm parameters and to delay ART management for three months in men who have been diagnosed with COVID-19 and developed a fever (Hamdi et al, 2020).…”

COVID-19: semen impairment may not be related to the virus

“…In infertile men with altered sperm parameters in the basal state, this fever could have a more deleterious impact. For this reason, it has already been recommended to monitor sperm parameters and to delay ART management for three months in men who have been diagnosed with COVID-19 and developed a fever ( Hamdi et al , 2020 ).…”