Could SARS-CoV-2 affect male fertility?

Area of Science:

• Reproductive biology and virology.

Background:

• The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) utilizes the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry.
• Previous research indicates that SARS-CoV-1 adversely affected testicular architecture, suggesting a potential risk for SARS-CoV-2.

Purpose of the Study:

• To systematically review and evaluate the potential impact of SARS-CoV-2 infection on male fertility.
• To analyze testicular expression of ACE2 in relation to SARS-CoV-2 infection.

Main Methods:

• Systematic literature review.
• Analysis of transcriptome sequencing data for ACE2 expression in testicular germ cells (human and rat).
• Review of studies examining SARS-CoV-2 presence in semen samples.

Main Results:

• ACE2 expression was confirmed in human spermatozoa and rat testicular germ cells.
• Transcriptome data revealed ACE2 expression in germ, Sertoli, and Leydig cells.
• Conflicting reports exist regarding SARS-CoV-2 detection in semen, creating uncertainty about sexual transmission.

Conclusions:

• The widespread expression of ACE2 across testicular cells suggests SARS-CoV-2 can potentially infect these cells.
• Given ACE2 presence and prior SARS-CoV impact, SARS-CoV-2 is likely to affect testicular tissue, semen parameters, and male fertility.
• Further research is needed to clarify SARS-CoV-2 presence in semen and its implications for male reproductive health.