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

Gacci, Mauro; Coppi, Marco; Baldi, Elisabetta; Sebastianelli, Arcangelo; Zaccaro, Claudia; Morselli, Simone; Pecoraro, Alessio; Manera, Alekseja; Nicoletti, Rossella; Liaci, Andrea; Bisegna, Claudio; Lepri, Gemma; Giancane, S.; Pollini, Simona; Antonelli, Alberto; Lagi, Filippo; Marchiani, Sara; Dabizzi, Sara; Nicolò, Sabrina; Torcia, Maria Gabriella; Degl'Innocenti, S; Annunziato, Francesco; Maggi, Mario; Vignozzi, Linda; Bartoloni, Alessandro; Rossolini, Gian María; Serni, Sergio

doi:10.1093/humrep/deab083

Cited by 3 publications

(6 citation statements)

References 11 publications

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“…The viral load may directly induce the testicular damage 24 or indirectly through the immune response, either innate or adaptive, activated to fight against the virus 25 . In addition, the testicular damage can be due to the high local temperatures reached during viral dissemination 26,27 …”

Section: Discussionmentioning

confidence: 99%

Male reproductive system inflammation after healing from coronavirus disease 2019

et al. 2021

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Background: There is evidence that, after severe acute respiratory syndrome coronavirus 2 infection, male reproductive function and semen quality may be damaged Objectives: To evaluate a panel of inflammatory mediators in semen in patients recovered from coronavirus disease 2019. Material and methods:Sexually active men with previous severe acute respiratory syndrome coronavirus 2 infection and proven recovery from coronavirus disease 2019 were enrolled in a prospective cohort study. Clinical, uro-andrological data and semen specimens were prospectively collected. For previously hospitalized coronavirus disease 2019 patients, data on serum inflammatory markers were retrospectively collected.Results: A total of 43 men were enrolled in the study. Of these, 32 men were normozoospermic, three were oligozoospermic, and eight were crypto-azoospermic. Serum inflammatory markers (procalcitonin and C-reactive protein) were analyzed in previously hospitalized patients both at admission and at peak of infection. Levels at admission were statistically significantly higher in patients resulting in crypto-azoospermic with respect to those resulting in normozoospermic (p = 0.05; p = 0.03 and p = 0.02,

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Section: Discussionmentioning

confidence: 99%

Male reproductive system inflammation after healing from coronavirus disease 2019

et al. 2021

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“…Furthermore, evidence suggests that both testicular function and semen quality may be reduced following severe COVID-19, due to several aspects of the disease including high fever and medications, indicating the need for andrological evaluation of recovered men 7,9 . Such a recommendation is also indicated in the o cial website of the government of Hubei Province which posted a bulletin inviting all men recovered from SARS-CoV-2 to undergo fertility checks, suggesting a big concern for a possible link between this novel disease and the male reproductive system 20 .…”

Section: Discussionmentioning

confidence: 98%

Persistent Male Genital Tract Inflammation and Semen Impairment: A Long-Term Effect of SARS-Cov-2 Infection

Gacci

Baldi

Sebastianelli

et al. 2021

Preprint

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Background: Recent reports evidenced an impairment of semen parameters in men affected by coronavirus disease 2019 (COVID-19). In particular, our group previously reported that 1 over 4 COVID-19 healed men were found to be crypto- / azoo-spermic. Moreover, most patients had elevated IL-8 semen levels at sperm analysis. The aim of our study was to assess semen parameters and inflammation by evaluating a panel of sperm cytokine levels (IL-1, IL-4, IL-6, IL-8, IL-17, INF gamma, TNF-alpha) on average 1 month after the second SARS-CoV-2 negative nasopharyngeal swab and 3 months later. Methods: Ten men who showed normozoospermia (n=3), oligozoospermia (n=3) or crypto/azoospermia (n=4) 1 month after healing from COVID-19 in our previous study, were re-called and re-evaluated 3 months after the first semen analysis. Semen parameters were evaluated according to WHO manual and seminal plasma cytokine levels by an ELISA method. Results: At 3-months follow-up, 8 men showed an overall increase of semen parameters compared to levels assessed after 1 month. In particular, of the 4 crypto-/azoo-spermic men 1 month after healing, 2 resulted oligozoospermic, 1 normozoospermic and only 1 remained azoospermic. Two of the 3 oligozoospermic men turned normozoozpermic. Semen cytokine levels were remarkably high one month after healing and remained elevated after 3 months, with the exception of IL-6. Conclusions: This is the first longitudinal, prospective study comparing semen parameters and semen inflammatory markers one and three months after recovering from COVID-19. Our data indicate an overall tendency to an improvement of semen parameters although a genital tract inflammatory condition appears to persist at least 3 months after COVID-19 recovery. This condition could have an impact on male fertility requiring a careful follow up of these patients.

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“…On the contrary, several other reported studies indicate that SARS-CoV-2 infection exerts adverse effects on sperm quality and male fertility potential. It has been shown that clinically severe or mild and even asymptomatic SARS-CoV-2 infection was followed by a decline in semen volume and sperm concentration, total sperm counts, motility and/or viability (Holtmann et al, 2020;Erbay et al, 2021;Gacci et al, 2021;Koc and Keseroglu, 2021;Pazir et al, 2021;Aksak et al, 2022;Ertas et al, 2022). Nevertheless, if such diseaseassociated deleterious effects on sperm quality are reversible or long lasting is still uncertain since scarce data has been reported in that regard (Guo et al, 2021;Donders et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…As conflicting data about COVID-19 and sperm quality has been reported (Gacci et al, 2021;Gupta et al, 2021;Patel et al, 2021; Frontiers in Physiology frontiersin.org Aksak et al, 2022;Che et al, 2022;Corona et al, 2022;Nassau et al, 2022;Tufvesson et al, 2022;Paoli et al, 2023), the potential reversibility of the observed impaired sperm quality after more than 1 spermatogenesis cycle was analyzed. To do that, sperm quality was analyzed comparing available baseline data from every patient before the infection and early (less than 3 months) 3D-G; Supplementary Table S2).…”

Section: Covid-19 Associated Sperm Quality Impairments Are Reversiblementioning

confidence: 99%

“…In that regard, and although still under debate, cumulative reported evidence indicates that SARS-CoV-2 infection impairs and it may actually have detrimental consequences on male fertility. In fact, it has been shown that COVID-19 negatively correlates with sperm quality parameters such as volume, concentration, motility, and viability, these changes often correlating with disease severity (Gacci et al, 2021;Guo et al, 2021). Interestingly, a systematic review and meta-analysis has shown that mild/asymptomatic COVID-19 also has detrimental effects on sperm quality by decreasing sperm concentration, total sperm count, progressive and total sperm motility, and normal sperm morphology (Che et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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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.

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

Cited by 3 publications

References 11 publications

Male reproductive system inflammation after healing from coronavirus disease 2019

Male reproductive system inflammation after healing from coronavirus disease 2019

Persistent Male Genital Tract Inflammation and Semen Impairment: A Long-Term Effect of SARS-Cov-2 Infection

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

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