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The probable destructive mechanisms behind COVID-19 on male reproduction system and fertility
Mojgan Moshrefi1,2,3, Saeed Ghasemi-Esmailabad2, Jaffar Ali4
1Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Purpose:
The present study aims to summarize the current understanding of probable mechanisms and claims of adverse effects of SARS-CoV-2 on male fertility potential.
Methods:
Our search was including original articles, reviews, guidelines, letters to the editor, comments on guidelines, and editorials, regarding the male reproductive system. We used the words SARS-CoV-2, coronavirus, severe acute respiratory syndrome coronavirus 2, "2019 ncov," testis, sperm, male factor infertility, fertility treatment, semen, assisted reproductive technology (ART), sexual transmission, and ACE2.
Results:
Data showed coronavirus affects men more than women because of more expression of 2019 nCoV receptors (ACE2 and TMPRSS2) in testicular cells. Also, "Bioinformatics Analysis" suggests that sperm production may be damaged, since "Pseudo Time Analysis" has shown disruption in spermatogenesis. "Gene Ontology" (GO) showed an increase in viral reproduction and a decrease in sperm production-related terms. Recently, SARS-COV-2 mRNA and protein were detected in the semen of patients that had recovered from SARS-CoV-2 infection. Therefore, the probable disruption of blood-testis barrier (BTB) in febrile diseases is suspected in the acute phase of the disease enabling viral entry into the testes. Not only is spermatogenesis disturbed, but also disturbs gonadotropin, androgens, and testosterone secretion during SARS-CoV-2 infection. No sexual transmission has been reported yet; however, detection of the virus in semen still makes the sexual transmission an open question.
Conclusion:
There is a concern that male fertility may be disturbed after the SARS-CoV-2 infection. Therefore, follow-up of the reproductive functions and male fertility may be necessary in recovered cases, especially in aged men.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may negatively impact male fertility by affecting sperm production and hormone secretion. Further monitoring of reproductive health is recommended for recovered individuals, particularly older men.
Area of Science:
- Reproductive Endocrinology
- Virology
- Male Infertility
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised concerns regarding its potential impact on male reproductive health.
- Understanding the specific mechanisms of SARS-CoV-2 on male fertility is crucial for clinical management and patient counseling.
Purpose of the Study:
- To review and summarize the current knowledge on the probable mechanisms and adverse effects of SARS-CoV-2 on male fertility potential.
- To consolidate findings regarding viral impact on testicular cells, spermatogenesis, and reproductive hormones.
Main Methods:
- Comprehensive literature search including original articles, reviews, and guidelines.
- Keywords used: SARS-CoV-2, coronavirus, testis, sperm, male factor infertility, semen, ACE2, and assisted reproductive technology (ART).
Main Results:
- SARS-CoV-2 affects males more due to higher expression of viral receptors (ACE2, TMPRSS2) in testicular cells.
- Bioinformatics and Gene Ontology analyses suggest impaired sperm production and spermatogenesis.
- SARS-CoV-2 RNA and protein detected in semen of recovered patients; disruption of the blood-testis barrier is suspected.
- Impact on gonadotropin, androgen, and testosterone secretion observed.
Conclusions:
- SARS-CoV-2 infection raises concerns about potential disturbances in male fertility.
- Regular follow-up of reproductive functions and fertility is advised for recovered individuals, especially older men.
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