SARS-CoV-2 Infection and the Male Reproductive System: A Brief Review

Rago, Vittoria; Perri, Anna

doi:10.3390/life13020586

Cited by 3 publications

(1 citation statement)

References 78 publications

(88 reference statements)

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“…A conclusion about these topics could be important for couples that are ART candidates, as it may be suggested to advise infertile couples to postpone parenthood research or ART procedures around 3 months after recovery from the infection to maximize their chances of getting pregnant, due to evidence of temporary alterations of sperm DNA integrity close to the recovery. Moreover, a conclusion regarding these issues could be crucial for men undergoing procedures to cryopreserve male gametes [ 103 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on testicular function: a systematic review and meta-analysis

Cannarella,

Marino,

Crafa

et al. 2024

Endocrine

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Introduction Studies investigating the effects of SARS-CoV-2 on male reproductive function are few and heterogeneous, and results are often conflicting. This systematic review and meta-analysis was carried out on studies conducted in men with active or anamnestic SARS-CoV-2 infection to evaluate its consequences on the male sex hormone profile and semen parameters. Materials and method This meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. PubMed, Scopus, Cochrane, and Embase databases were searched to identify relevant studies. We originally selected 3553 articles. After the eligibility phase, 16 articles met our inclusion criteria encompassing 11 case-control studies and 5 cohort studies (2 prospective and 3 retrospective studies). We performed the quantitative analysis with Comprehensive Meta-Analysis Software. Cochran-Q and heterogeneity (I2) indexes were used to assess statistical heterogeneity. Sensitivity analysis and publication bias tests were also performed. Results Overall, 1250 patients with active or recent (up to 80 days before) COVID-19 infection and 1232 matched healthy controls were included. Sperm concentration, total sperm count, and total motility were significantly lower in patients compared with controls. Patients also showed lower levels of total testosterone and follicle-stimulating hormone, and higher levels of luteinizing hormone, 17β-estradiol, and prolactin compared with healthy controls. None of the included studies found the presence of SARS-CoV-2 mRNA in the semen of infected patients. Conclusion The present systematic review and meta-analysis suggests the presence of an association between SARS-CoV-2 infection and primary testicular damage manifested with a picture of altered steroidogenesis and worsening spermatogenesis. The absence of the virus in the seminal fluid indicates a low possibility of sexual transmission of the infection to partners and offspring. However, our findings mostly show short-term follow-up, while few studies have considered the long-term consequences of the viral infection, thus further studies are needed to evaluate the long-term consequences on male reproductive health.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on testicular function: a systematic review and meta-analysis

Cannarella,

Marino,

Crafa

et al. 2024

Endocrine

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Update on known and emergent viruses affecting human male genital tract and fertility

Dabizzi,

Maggi,

Torcia

2024

Basic Clin. Androl.

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Many viruses infect the male genital tract with harmful consequences at individual and population levels. In fact, viral infections may induce damage to different organs of the male genital tract (MGT), therefore compromising male fertility. The oxidative stress, induced during viral-mediated local and systemic inflammation, is responsible for testicular damage, compromising germinal and endocrine cell functions. A reduction in sperm count, motility, number of normal sperm and an increase in DNA fragmentation are all common findings in the course of viral infections that, however, generally regress after infection clearance. In some cases, however, viral shedding persists for a long time leading to unexpected sexual transmission, even after the disappearance of the viral load from the blood.The recent outbreak of Zika and Ebola Virus evidenced how the MGT could represent a reservoir of dangerous emergent viruses and how new modalities of surveillance of survivors are strongly needed to limit viral transmission among the general population.Here we reviewed the evidence concerning the presence of relevant viruses, including emergent and re-emergent, on the male genital tract, their route of entry, their adverse effects on male fertility and the pattern of viral shedding in the semen.We also described laboratory strategies to reduce the risk of horizontal or vertical cross-infection in serodiscordant couples undergoing assisted reproductive technologies.

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A narrative literature review of remaining male reproductive health concerns as an aspect of persistent/late-onset complications of COVID-19

Allahveisi,

Afradiasbagharani,

Bazrafkan

et al. 2023

Middle East Fertil Soc J

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Background Although COVID-19 infection has dropped across the world and SARS-CoV-2 vaccines have been developed, global concerns remain about the disease’s long-term health consequences. The purpose of this research was to review the consequences of SARS-CoV-2 on male health, particularly the reproductive system and the pathogenic mechanisms affecting male infertility. Improving knowledge on these issues may help in considering to which extent some of the remaining concerns should be addressed. Results The primary target of this disease is the pulmonary system, but reproductive organs may be targeted by the virus. To enter host cells, the virus utilizes both ACE2 and TMPRSS2, which are differentially expressed in the spermatogonial stem, Leydig, and Sertoli cells, thereby providing possible testicular vulnerability. COVID-19-related stress and psychological distress may also affect aspects of male reproductive health. Conclusions Since some pathological effects of COVID-19 infection and dysregulations are linked to infertility, more attention is needed to determine whether such dysregulations regress following infection decline.

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SARS-CoV-2 Infection and the Male Reproductive System: A Brief Review

Cited by 3 publications

References 78 publications

Impact of COVID-19 on testicular function: a systematic review and meta-analysis

Impact of COVID-19 on testicular function: a systematic review and meta-analysis

Update on known and emergent viruses affecting human male genital tract and fertility

A narrative literature review of remaining male reproductive health concerns as an aspect of persistent/late-onset complications of COVID-19

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