COVID-19 associates with semen inflammation and sperm quality impairment that reverses in the short term after disease recovery

Abstract

Introduction: COVID-19 exerts deleterious effects on the respiratory, cardiovascular, gastrointestinal, and central nervous systems, causing more severe disease in men than in women. However, cumulative reported data about the putative consequences on the male reproductive tract and fertility are controversial. Furthermore, the long-term effects of SARS-CoV-2 infection are still uncertain.Methods: In this study, we prospectively evaluated levels of inflammatory cytokines and leukocytes in semen and sperm quality parameters in a cohort of 231 reproductive-aged male patients, unvaccinated, who had recovered from mild or severe COVID-19 and in 62 healthy control individuals. Sperm quality was assessed early (less than 3 months) and long (more than 3 and up to 6 months) after having COVID-19. Interestingly, and unlike most reported studies, available extensive background and baseline data on patients’ sperm quality allowed performing a more accurate analysis of COVID-19 effects on sperm quality.Results: Significantly higher levels of IL-1β, TNF and IFNγ were detected in semen from patients recently recovered from mild and/or severe COVID-19 with respect to control individuals indicating semen inflammation. Moreover, patients recovered from mild and/or severe COVID-19 showed significantly reduced semen volume, lower total sperm counts, and impaired sperm motility and viability. Interestingly, all observed alterations returned to baseline values after 3 or more months after disease recovery.Discussion: These results indicate that COVID-19 associates with semen inflammation and impaired semen quality early after disease. However, long COVID-19 seems not to include long-term detrimental consequences on male fertility potential since the observed alterations were reversible after 1-2 spermatogenesis cycles. These data constitute compelling evidence allowing a better understanding of COVID-19 associated sequelae, fundamental for semen collection in assisted reproduction.

Age-Related COVID-19 Influence on Male Fertility

“…We assessed standard sperm quality parameters in patients younger and older than 35 years, 5-7 months after recovery from COVID-19. In many studies, the recovery period for sperm parameters is 1 or 2 cycles of spermatogenesis [7,16,28,29]. This may explain why we did not find statistically significant differences in the studied markers.…”

“…According to recent reports, various levels of cytokines are typically found in seminal plasma within normal ranges [30]. However, even 2-3 months after recovering from COVID-19, alterations in the levels of both pro-inflammatory cytokines, such as IL-1β, IL-6, TNFα, and the anti-inflammatory cytokine IL-10, have been observed in semen [11,16]. Additionally, Yu et al have suggested that the cytokine storm in COVID-19 patients is associated with enhanced levels of 13 specific cytokines (including IL-1, IL-6, IL-10, and TNFα), potentially affecting male fertility through damage to testicular cells and impairment of the immune microenvironment [31].…”

“…Additionally, higher Zn levels are associated with better clinical outcomes during coronavirus infection [13]. It is very likely that the coronavirus-induced increase in inflammatory markers not only in the blood [14,15] but also in the seminal plasma of patients, which indicates inflammation in the sperm [11,16], may be caused by a decrease in Zn levels in the body. However, the observed changes in inflammatory markers return to baseline values within three months or more after recovery [16].…”

The remarkable ups and downs of birth rate in Switzerland 2020 to 2023 in a historical context

“…Where there is a relatively large body of evidence, however, is how single and multiple COVID-19 infections can harm male and female fertility (Aksak et al, 2022; Chen et al, 2021; Harb et al, 2022; Hosseini et al, 2023; Martinez et al, 2023; Patel et al, 2021; Saadedine et al, 2023; Wesselink et al, 2022). And this could be one of the reasons for the decline in births in the second half of 2022.…”

Eliminating COVID‐19 as the immediate culprit for igniting pancreatitis

“…Individuals infected with COVID‐19 often exhibit symptoms such as cephalalgia, rhinorrhea, sneezing, pharyngitis, anosmia, and ageusia. Nevertheless, it is worth noting that a significant proportion of patients, around 80%, may have long‐term complications affecting various bodily systems, such as the neurological, 2 urogenital, 3 and digestive systems 4 diseases over the weeks or months after their recovery. The consequences of COVID‐19 exhibit a range of severity, which may be attributed to substantial variations among individuals.…”