SARS-CoV-2 in the semen: Where does it come from?

Area of Science:

• Reproductive Medicine
• Virology
• Urology

Background:

• Recent reports indicate SARS-CoV-2 presence in semen, raising concerns about male reproductive tract infection and sexual transmission.
• The safety of fertility treatments during the COVID-19 pandemic remains a critical consideration.

Purpose of the Study:

• To investigate potential sites of SARS-CoV-2 infection within the male reproductive system.
• To review current data and hypotheses regarding male genital tract infection by SARS-CoV-2.

Main Methods:

• Literature review focusing on angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) expression in male reproductive and urinary tracts.
• Examination of other coronavirus (SARS, MERS) infectivity in these sites.

Main Results:

• ACE2 and TMPRSS2 co-expression is found in testicular cells, prostate, and renal tubules.
• Testicular damage was noted in SARS patients, though the virus was not detected.
• SARS-CoV-2 RNA has been detected in urine; prostate involvement is theoretically possible.

Conclusions:

• The potential for SARS-CoV-2 to infect the male reproductive tract and pass the blood-testis barrier requires further investigation.
• Understanding potential viral shedding in semen and its implications for sexual transmission and fertility is crucial.