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Ahmed MA, Obaid ZM, Hashem O, Elrifai AW, Elsaie ML. Prevalence of new onset erectile dysfunction among Damietta governorate men after contracting COVID-19. Ir J Med Sci 2024; 193:1581-1587. [PMID: 38245885 PMCID: PMC11128385 DOI: 10.1007/s11845-024-03610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Several reports showed that sexual function was affected during and after the COVID-19 pandemic. AIMS The objective of the study was to demonstrate whether a realistic association exists between the COVID-19 pandemic and erectile dysfunction (ED) among a sampled Egyptian population in Damietta governorate. METHODS This cross-sectional study consisted of 330 adult males diagnosed with COVID-19 infection. They were categorized in three age groups (18-29, 30-39, and 40-50 years, respectively). COVID-19-confirmed cases were assessed by the Arabic version of the International Index of Erectile Function questionnaire (IIEF) scores. RESULTS The prevalence of ED according to the IIEF was 55.1%. The ED was categorized into mild ED which represents 25.8% of the patients, mild to moderate which represents 22.4% of the patients, moderate which represents 7% of the patients, and severe which represents 0% of the patients. We found a significant negative correlation between the age of the patients and the IIEF score. Also, we found an association between the severity of COVID-19 infection and the IIEF score. CONCLUSION An association of new-onset ED in men who suffered COVID-19 infection was established. This may be due to virus-induced endothelial cell dysfunction; however, an underlying mechanism and causation have not yet been clearly elucidated. While it appears that COVID-19 infection may be a risk factor for ED, additional research is needed to establish causality.
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Affiliation(s)
- Mostafa A Ahmed
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Zakaria M Obaid
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Osama Hashem
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Atef W Elrifai
- Department of Pulmonology, Damietta, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Venereology and Andrology, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt.
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Abou Chawareb E, Nakamura H, Hammad MAM, Miller JA, Lumbiganon S, Azad BK, Yafi FA. Search traffic for inflatable penile prosthesis increased following the COVID-19 pandemic in the United States: a Google Trends analysis. Int J Impot Res 2024:10.1038/s41443-024-00922-6. [PMID: 38816575 DOI: 10.1038/s41443-024-00922-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
We aimed to determine the impact of the COVID-19 pandemic on search trends for inflatable penile implants in the US. Search trends for inflatable penile implants ranging from 2016 through 2023 were analyzed utilizing Google Trends. Associations between search trends and US Census Bureau data, including average household income and per capita income, were analyzed. Pre- and post- COVID-19, the interest in inflatable penile implants has been steadily increasing on average in the US. The average household income for counties with the highest interest in inflatable penile implants during the pre-COVID era was $53,136, whereas for the counties with the highest interest in inflatable penile implants in the post-COVID era, the average decreased to $50,940. Similarly, the average per capita median decreased from $35,209 to $34,547. Search traffic for inflatable penile prosthesis increased following the pandemic in the US. Nevertheless, post-pandemic, individuals with lower income levels showed no change in interest in penile implant searches compared to the pre-pandemic period. Understanding this steadiness in interest can inform healthcare professionals and policymakers to tailor interventions and educational efforts to reach a broader audience, ensuring equitable access to information and healthcare resources.
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Affiliation(s)
| | - Hana Nakamura
- Department of Urology, University of California, Irvine, CA, USA
| | | | - Jake A Miller
- Department of Urology, University of California, Irvine, CA, USA
| | - Supanut Lumbiganon
- Department of Urology, University of California, Irvine, CA, USA
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Babak K Azad
- Department of Urology, University of California, Irvine, CA, USA
| | - Faysal A Yafi
- Department of Urology, University of California, Irvine, CA, USA
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3
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Chopra P, Tomar AK, Thapliyal A, Ranjan P, Datta SK, Yadav S. Quantitative Proteomics of COVID-19 Recovered Patients Identifies Long-Term Changes in Sperm Proteins Leading to Cellular Stress in Spermatozoa. Reprod Sci 2024:10.1007/s43032-024-01560-5. [PMID: 38658489 DOI: 10.1007/s43032-024-01560-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
Following an initial recovery, COVID-19 survivors struggle with a spectrum of persistent medical complications, including fatigue, breathlessness, weight loss, hair loss, and attention deficits. Additionally, there is growing evidence of adverse effects of COVID-19 on the male reproductive system. This investigation seeks to understand the long-term ramifications on male fertility by examining hormonal profiles, semen parameters, and sperm proteome of recovered COVID-19 patients compared to controls. The serum hormone profiles between the two groups showed minimal variations except for prolactin, cortisol, and testosterone levels. Testosterone levels were slightly lower, while prolactin and cortisol were elevated in COVID-19 cases compared to controls. Though semen parameters exhibited no significant disparities between the COVID-19 and control groups, quantitative proteomics analysis revealed changes in sperm proteins. It identified 190 differentially expressed proteins, of which 161 were upregulated and 29 downregulated in COVID-19 cases. Western blotting analysis validated the differential expression of serpin B4 and calpain 2. Bioinformatics analysis signifies cellular stress in the spermatozoa of COVID-19 recovered patients and thus, SOD and MDA levels in semen were measured. MDA levels were found to be significantly elevated, indicating lipid peroxidation in COVID-19 samples. While the effects of COVID-19 on semen parameters may exhibit a potential for reversal within a short duration, the alterations it inflicts on sperm proteome are persisting consequences on male fertility. This study paves the path for further research and emphasizes the significance of comprehending the complex molecular processes underlying the long-term consequences of COVID-19 on male reproductive health.
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Affiliation(s)
- Parul Chopra
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Anil Kumar Tomar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ayushi Thapliyal
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sudip Kumar Datta
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Savita Yadav
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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4
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Li JZ, Wu H, Wang L, Wang YS, Kong F, Cao LQ, Liang M, Wang X, Yuan MZ. Male reproductive function before and after the adjustment of the COVID-19 prevention policy: a multicenter study in China. Asian J Androl 2024:00129336-990000000-00176. [PMID: 38639721 DOI: 10.4103/aja202388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/25/2023] [Indexed: 04/20/2024] Open
Abstract
At the end of 2022, the adjustment of the coronavirus disease 2019 (COVID-19) pandemic control policy in China resulted in a large-scale increase in public infection. To compare the fertility parameters of male patients before and after the adjustments of the COVID-19 pandemic control policy in China, we collected data on patients' medical histories and laboratory examinations on their first visits between June 2022 and March 2023 in five different hospitals. Data were divided into five groups according to the timeline of the policy adjustment. The data we collected from male patients included semen quality and serum reproductive hormone levels, and intergroup comparisons were made using the Mann-Whitney U and Chi-square tests. In total, 16 784 cases underwent regular semen analysis, 11 180 had sperm morphology assessments, and 7200 had reproductive hormone analyses. The data showed declining trends in semen volume, sperm motility, and the progressive sperm motility rate after the policy adjustment. Subgroup comparison revealed an initial decrease and gradual recovery in progressive motility rate. Sperm morphology analysis showed increased neck and tail abnormalities after the policy adjustment. No significant change in hormone levels was observed. Following the adjustment of the COVID-19 prevention policy in China, a decline in sperm motility and morphology was observed. This trend may gradually recover over 2 months. After the policy adjustment, reproductive hormone levels were relatively stable throughout, except for an increase in luteinizing hormone (LH). These changes in semen parameters suggest that the policy adjustment had a short- to medium-term impact on male reproductive function.
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Affiliation(s)
- Jian-Zheng Li
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, China
| | - Han Wu
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan 250012, China
| | - Li Wang
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan 250012, China
| | - Yun-Shan Wang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, China
| | - Feng Kong
- Engineering Laboratory of Urinary Organ and Functional Reconstruction of Shandong Province, Jinan 250000, China
| | - Long-Qiao Cao
- The First People's Hospital of Jining, Jining 272000, China
| | - Ming Liang
- Department of Reproductive Medicine, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, China
| | - Xiong Wang
- Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, China
| | - Ming-Zhen Yuan
- Institute of Women, Children and Reproductive Health, Shandong University, Jinan 250012, China
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5
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Zhang G, Zhi W, Ye F, Xiong D, Zhang Y, Liu F, Zhao Y, Du X, Wu Y, Hou M, Liu J, Wei J, Silang Y, Xu W, Zeng J, Chen S, Liu W. Systematic analyses of the factors influencing sperm quality in patients with SARS-CoV-2 infection. Sci Rep 2024; 14:8132. [PMID: 38584153 PMCID: PMC10999436 DOI: 10.1038/s41598-024-58797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/03/2024] [Indexed: 04/09/2024] Open
Abstract
To figure out how does SARS-CoV-2 affect sperm parameters and what influencing factors affect the recovery of sperm quality after infection? We conducted a prospective cohort study and initially included 122 men with SARS-CoV-2 infection. The longest time to track semen quality after infection is 112 days and 58 eligible patients were included in our study eventually. We subsequently exploited a linear mixed-effects model to statistically analyze their semen parameters at different time points before and after SARS-CoV-2 infection. Semen parameters were significantly reduced after SARS-CoV-2 infection, including total sperm count (211 [147; 347] to 167 [65.0; 258], P < 0.001), sperm concentration (69.0 [38.8; 97.0] to 51.0 [25.5; 71.5], P < 0.001), total sperm motility (57.5 [52.3; 65.0] to 51.0 [38.5; 56.8], P < 0.001), progressive motility (50.0 [46.2; 58.0] to 45.0 [31.5; 52.8], P < 0.001). The parameters displayed the greatest diminution within 30 days after SARS-CoV-2 infection, gradually recovered thereafter, and exhibited no significant difference after 90 days compared with prior to COVID-19 infection. In addition, the patients in the group with a low-grade fever showed a declining tendency in semen parameters, but not to a significant degree, whereas those men with a moderate or high fever produced a significant drop in the same parameters. Semen parameters were significantly reduced after SARS-CoV-2 infection, and fever severity during SARS-CoV-2 infection may constitute the main influencing factor in reducing semen parameters in patients after recovery, but the effect is reversible and the semen parameters gradually return to normal with the realization of a new spermatogenic cycle.
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Affiliation(s)
- Guohui Zhang
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study and the Center for Medical Genetics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, 610072, China
| | - Weiwei Zhi
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Fei Ye
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Dongsheng Xiong
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Yanan Zhang
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Fulin Liu
- Sichuan Provincial Key Laboratory for Human Disease Gene Study and the Center for Medical Genetics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, 610072, China
| | - Yuhong Zhao
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, 610500, China
| | - Xinrong Du
- Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yang Wu
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Mingxia Hou
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Jiu Liu
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Jiajing Wei
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Yangzhong Silang
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Wenming Xu
- Department of Obstetrics and Gynecology, Joint Laboratory of Reproductive Medicine (SCU-CUHK), Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Jiuzhi Zeng
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China.
| | - Shiqi Chen
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China.
| | - Weixin Liu
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China.
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Chen F, Zhang Y, Zhang Y, Li Y, Ma J, Qin Y, Deng S, Zhang Y, Wang D, Wang H, Lin J. Effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus (COVID-19) vaccination on male fertility. Sex Health 2024; 21:SH23191. [PMID: 38538087 DOI: 10.1071/sh23191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024]
Abstract
Coronavirus disease 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains an ongoing global public health challenge. This disease causes damage not only to the respiratory system, affecting the normal physiological function of the lungs, but also to other vital organs, such as the heart and testicles. Existing studies have shown that co-expression of angiotensin-converting enzyme 2 and transmembrane serine protease 2 is the main mechanism by which SARS-CoV-2 invades host cells. Angiotensin-converting enzyme 2-expressing cells are widespread in the corpus cavernosum, reproductive tract and testis of men, which has raised concerns. Furthermore, abnormal sex hormone levels and decreased semen parameters were observed in coronavirus disease 2019 patients. This study comprehensively assessed the effects of SARS-CoV-2 infection on the testis, semen parameters, sex hormone levels and erectile function, and discussed possible transmission routes during sexual intercourse and the effect of vaccination on male fertility.
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Affiliation(s)
- Fei Chen
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yunfei Zhang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yingze Zhang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yuqi Li
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Jiao Ma
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yining Qin
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Shuwen Deng
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yuhan Zhang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Deyang Wang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Haiying Wang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Juan Lin
- Jining Medical University, 133 Hehua Road, Jining 272067, China
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7
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Dong Y, Ba Z, Qin Y, Ma J, Li Y, Zhang Y, Yang A, Chen F. Comprehensive evaluation of inactivated SARS-CoV-2 vaccination on sperm parameters and sex hormones. Front Immunol 2024; 15:1321406. [PMID: 38469318 PMCID: PMC10925671 DOI: 10.3389/fimmu.2024.1321406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
Background The inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine has made significant contributions to fighting the epidemic in the past three years. However, the rapid development and application raised concerns about its safety in reproductive health, especially after several studies had observed a decrease in semen parameters following two doses of mRNA SARS-CoV-2 vaccination. Thus, it is necessary to comprehensively evaluate the effect of inactivated SARS-CoV-2 vaccine on male fertility. Methods A retrospective cohort study was conducted in the Center for Reproductive Medicine of the Affiliated Hospital of Jining Medical University between July 2021 and March 2023. A total of 409 men with different vaccination status and no history of SARS-CoV-2 infection were included in this study. Their sex hormone levels and semen parameters were evaluated and compared separately. Results The levels of FSH and PRL in one-dose vaccinated group were higher than other groups, while there were no significant changes in other sex hormone levels between the control and inactivated SARS-CoV-2 vaccinated groups. Most semen parameters such as volume, sperm concentration, total sperm count, progressive motility and normal forms were similar before and after vaccination with any single dose or combination of doses (all P > 0.05). Nevertheless, the total motility was significantly decreased after receiving the 1 + 2 doses of vaccine compared to before vaccination (46.90 ± 2.40% vs. 58.62 ± 2.51%; P = 0.001). Fortunately, this parameter was still within the normal range. Conclusion Our study demonstrated that any single dose or different combined doses of inactivated SARS-CoV-2 vaccination was not detrimental to male fertility. This information could reassure men who want to conceive after vaccination and be incorporated into future fertility recommendations.
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Affiliation(s)
- Yehao Dong
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Zaihua Ba
- Department of Physiology, Jining Medical University, Jining, China
| | - Yining Qin
- Department of Physiology, Jining Medical University, Jining, China
| | - Jiao Ma
- Department of Physiology, Jining Medical University, Jining, China
| | - Yuqi Li
- Department of Physiology, Jining Medical University, Jining, China
| | - Yingze Zhang
- Department of Physiology, Jining Medical University, Jining, China
| | - Aijun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, Jining, China
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Alzahrani MA, Alkhani KO, Alassaf AM, Alorainy JI, Binsaleh S, Almannie R. Updates in the pathophysiology of COVID-19 infection in male reproductive and sexual health: a literature review. Front Endocrinol (Lausanne) 2024; 14:1226858. [PMID: 38468633 PMCID: PMC10925715 DOI: 10.3389/fendo.2023.1226858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/26/2023] [Indexed: 03/13/2024] Open
Abstract
This extensive comprehensive review explores the impact of the Coronavirus disease 2019 (COVID-19) pandemic on men's sexual and reproductive health. We conducted a literature review focusing on the possible pathophysiology by which severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) affects men's sexual and reproductive systems. We reviewed most of the studies that reported the impact of SARS-CoV-2 infection on the Testicular, Epididymal, Prostatic, and Penile tissue. Also, we focused on evaluating the SARS-CoV-2 infection on semen parameters and male reproductive hormones. Finally, we reviewed the COVID-19 vaccine's effect on male reproductive and sexual health. Findings revealed the adverse consequences of SARS-CoV-2 at cellular and organ levels on the male genital tract. However, the reported data are still controversial. The initial data regarding COVID-19 vaccination was promising promoted safety for men's reproductive and sexual health. We conclude this paper by offering recommendations to address these adverse consequences and potentially improve sexual and reproductive health among men in the post-COVID-19 pandemic era.
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Affiliation(s)
- Meshari A. Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | | | | | | | - Saleh Binsaleh
- Department of Surgery, Urology Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Raed Almannie
- Department of Surgery, Urology Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Araújo ALM, de Almeida VLL, Costa TML, Mendonça ACG, Penna MLF, dos Santos A, Ramos MG. Evaluation of the effects of COVID-19 on semen parameters and male infertility. JBRA Assist Reprod 2024; 28:90-95. [PMID: 38091259 PMCID: PMC10936926 DOI: 10.5935/1518-0557.20230067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/21/2023] [Indexed: 03/16/2024] Open
Abstract
The new coronavirus pandemic resulted in millions of deaths in Brazil and around the world, and presented substantial challenges to society. The shortand long-term clinical manifestations tied to COVID-19 are still poorly understood, and may involve several organs and systems, including the male genital tract, which may lead to impaired fertility. The present study aimed to analyze, through an integrative literature review of articles available in databases, the effects of COVID-19 on parameters related to human semen quality. The analyzed studies reported significant decreases in sperm motility and morphology related to COVID-19. Reductions in concentration and volume were also observed. Inflammatory response is one of the leading mechanisms that may potentially explain the observed changes, although others may also be involved. More studies are needed to better understand the effects, modes of action, as well as other aspects involved in this complex phenomenon.
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Affiliation(s)
- Ana Lívia Mota Araújo
- Faculdade de Ciências Humanas, Sociais e da Saúde -
Universidade Fumec. Belo Horizonte, MG, Brazil
| | | | | | | | | | - Adriana dos Santos
- Faculdade de Ciências Humanas, Sociais e da Saúde -
Universidade Fumec. Belo Horizonte, MG, Brazil
| | - Mariana Gontijo Ramos
- Faculdade de Ciências Humanas, Sociais e da Saúde -
Universidade Fumec. Belo Horizonte, MG, Brazil
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10
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Lan X, Chen D, Wang M, Yu X, Dong L, Li J, Chang D, Yang F. The Effect of COVID-19 on Male Sex Hormones: A Meta-Analysis of Prospective Cohort Study. J Epidemiol Glob Health 2024:10.1007/s44197-024-00203-x. [PMID: 38407718 DOI: 10.1007/s44197-024-00203-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
PURPOSE To evaluate the possible effects of novel coronavirus disease 2019 (2019-NCOV) on male sex hormones and reproductive ability, and analyze its incidence and risk factors. METHODS We retrieved from PubMed, Embase, The Cochrane Library, Web of Science, Clinical Trails, CNKI, CBM, Wan Fang Database and VIP to collect research on the effects of COVID-19 on the male sex hormone. Our literature search was conducted until April 2022, and two investigators independently screened articles based on inclusion and exclusion criteria. In strict accordance with the inclusion and exclusion criteria, two researchers independently screened the literature and comprehensively analyzed 8 cohort studies on the impact of COVID-19 on male sex hormone. And We used RevMan5.4.1 and Stata15.0 for statistical analysis. Finally, there were eight cohort studies on the effects of COVID-19 on male sex hormones. RESULTS T(RR = - 3.94; 95% CI - 6.22, - 1.66; P = 0.0007), testosterone in the COVID-19 group decreased by 3.94 nmol/L compared with the control group, and the difference was statistically significant. LH (RR = 0.85; 95% CI - 0.26, 1.96; P = 0.13), the LH in COVID-19 group was 0.85 mlU/ml higher than that in control group, but the difference was not statistically significant. FSH (RR = 0.25; 95% CI - 0.72, 1.23; P = 0.61), the FSH of COVID-19 group was 0.25 mlU/ml higher than that of the control group, but the difference was not statistically significant. PRL (RR = 2.42; 95% CI 0.52, 4.31; P = 0.01), the PRL in the COVID-19 group was 2.42 ng/ml higher than that in the control group, and the difference was statistically significant. E2(RR = 11.88; 95% CI 9.90, 13.86; P < 0.00001), The level of E2 in the COVID-19 group was 11.88 pg/ml higher than that in the control group, and the difference was statistically significant. T:LH (RR = - 0.39; 95% CI - 076, - 0.02; P = 0.04), the ratio of T:LH in COVID-19 group was lower than that in control group, and the difference was statistically significant. FSH:LH (RR = - 0.38; 95% CI - 0.86, 0.11; P = 0.13), the ratio of FSH:LH decreased in COVID-19 group compared with control group, but the difference was not statistically significant. CONCLUSIONS COVID-19 can affect the level of sex hormones, especially T, which may further affect male fertility. Due to the limitations of this study, this conclusion needs to be further verified by large-sample, high-quality prospective cohort studies on the long-term effects of COVID-19 on male sex hormones and fertility.
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Affiliation(s)
- Xiucheng Lan
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 shi-er-qiao Road, Chengdu, 610072, Sichuan Province, China
| | - Diang Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 shi-er-qiao Road, Chengdu, 610072, Sichuan Province, China
| | - Meijing Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 shi-er-qiao Road, Chengdu, 610072, Sichuan Province, China
| | - Xujun Yu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liang Dong
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Junjun Li
- Chengdu Fifth People's Hospital, Chengdu, China
| | - Degui Chang
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 shi-er-qiao Road, Chengdu, 610072, Sichuan Province, China
| | - Fang Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 shi-er-qiao Road, Chengdu, 610072, Sichuan Province, China.
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Puspaningrat AAP, Hakim L, Renaldo J. Effect of SARS-CoV-2 viral infection on male sexual hormones levels post COVID-19 exposure: A systematic review and meta-analysis. Arch Ital Urol Androl 2024; 96:12113. [PMID: 38363236 DOI: 10.4081/aiua.2024.12113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION The COVID-19 can affect human testicles, thus will interfere the production of important male sexual hormone such as testosterone. Our study provides scientific evidence through systematic reviews and meta-analyses that focus on the effects of SARS-CoV-2 virus infection on male sexual hormonal disorders in patients post-exposure to COVID-19. METHODS This meta-analysis was made in accordance with the PRISMA guidelines. The outcomes of this study were the level of total testosterone, free testosterone, LH and FSH. Chi-square and I2 tests were used to evaluate heterogeneity between studies. The standardized mean deviation (SMD) with 95% CI were used and analysis was performed using the Review Manager 5.4 software. RESULTS The four included studies reported a total of 256 patients with COVID-19 with time of follow-up time post COVID-19 varying from one month to 7 months. The mean age distribution in the study was 34-57 years old. Total testosterone level (SMD = -158.71; 95% CI= -205.30 - -112.12; p<0.00001) was significantly higher at follow-up post COVID-19, while LH (SMD = 0.40; 95% CI = 0.15-0.65; p=0.002) was lower. The free testosterone level and FSH level showed no significant difference between baseline and after following up post COVID-19. CONCLUSIONS At follow up, the total testosterone level in patients with SARS-CoV-2 infection appeared to be elevated while LH was lower compared to the baseline.
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Affiliation(s)
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Universitas Airlangga; Universitas Airlangga Teaching Hospital, Surabaya.
| | - Johan Renaldo
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya; Universitas Airlangga Teaching Hospital, Surabaya.
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12
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Taieb A, Nassim BHS, Asma G, Jabeur M, Ghada S, Asma BA. The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review. Adv Respir Med 2024; 92:96-109. [PMID: 38392036 PMCID: PMC10886368 DOI: 10.3390/arm92010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body's stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.
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Affiliation(s)
- Ach Taieb
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
- Laboratory of Exercise Physiology and Pathophysiology, L.R.19ES09, Sousse 4054, Tunisia
| | - Ben Haj Slama Nassim
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Gorchane Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Methnani Jabeur
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
- Laboratory of Exercise Physiology and Pathophysiology, L.R.19ES09, Sousse 4054, Tunisia
| | - Saad Ghada
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Ben Abdelkrim Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
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13
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Ganesan S, Al Ketbi LM, Cantarutti FM, Al Kaabi N, Al Mansoori M, Al Saedi MR, Al Blooshi FI, Al Nuaimi RA, Ibrahim M, Eltantawy I, Al Marzooqi F, Zaher WA. Influence of COVID-19 pandemic on pregnancy and fertility preferences among the residents of the United Arab Emirates (UAE). J Glob Health 2024; 14:05002. [PMID: 38330200 PMCID: PMC10852539 DOI: 10.7189/jogh.14.05002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) significantly impacted the lifestyles of millions of people, with new challenges arising as the pandemic progresses. However, little attention has been given to issues like fertility intentions and pregnancy planning during COVID-19. Consequently, we aimed to investigate the influence of the pandemic on pregnancy and fertility decisions among the residents of the United Arab Emirates (UAE). Methods We surveyed UAE residents of reproductive age between November 2021 to June 2022 via the Google Forms platform and collected data on demographics, associated health conditions, COVID-19 infections, as well as plans for pregnancy and fertility intentions. We presented data through descriptive statistics (frequencies and percentages) and used Pearson's χ2 test to compare the characteristics of participants who reported that the COVID-19 pandemic has influenced their fertility preferences with those who reported that it had not. Results Overall, 564 participants completed the survey, of whom 115 (20.4%) stated that the COVID-19 pandemic had influenced their fertility preferences. Meanwhile, 234 (41.5%) reported previous history of COVID-19 infection; regarding post-COVID-19 infection symptoms, 53 (22.6%) reported decreased libido and 40 (17%) reported trouble in conceiving a baby. Participants who were ≤30 years of age were less likely to be influenced by the COVID-19 pandemic on their decision on fertility compared to those >30 years of age. Factors like education, income, chronic health conditions, and previous history of COVID-19 infection or vaccination did not have any significant effect on the COVID-19 pandemic influence on fertility preferences. Conclusions The COVID-19 pandemic has brought in new challenges which could affect fertility and this needs to be studied further for planning effective measures.
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Affiliation(s)
- Subhashini Ganesan
- G42 Healthcare, Abu Dhabi, United Arab Emirates
- Insights Research Organization and Solutions (IROS), Abu Dhabi, United Arab Emirates
| | | | - Flavia Martinez Cantarutti
- G42 Healthcare, Abu Dhabi, United Arab Emirates
- Insights Research Organization and Solutions (IROS), Abu Dhabi, United Arab Emirates
| | - Nawal Al Kaabi
- Ambulatory Healthcare Services, SEHA, Abu Dhabi, United Arab Emirates
| | | | | | | | | | - Marie Ibrahim
- Insights Research Organization and Solutions (IROS), Abu Dhabi, United Arab Emirates
| | - Islam Eltantawy
- Insights Research Organization and Solutions (IROS), Abu Dhabi, United Arab Emirates
| | | | - Walid Abbas Zaher
- G42 Healthcare, Abu Dhabi, United Arab Emirates
- Insights Research Organization and Solutions (IROS), Abu Dhabi, United Arab Emirates
- United Arab Emirates University, Abu Dhabi, United Arab Emirates
- Khalifa University, Abu Dhabi, United Arab Emirates
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14
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Salciccia S, Moriconi M, Asero V, Canale V, Eisenberg ML, Glover F, Belladelli F, Seranio N, Basran S, De Berardinis E, Di Pierro G, Ricciuti GP, Chung BI, Sciarra A, Del Giudice F. Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across hospitalized Covid-19 patients. Sci Rep 2024; 14:2786. [PMID: 38307934 PMCID: PMC10837199 DOI: 10.1038/s41598-024-53392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 01/31/2024] [Indexed: 02/04/2024] Open
Abstract
A growing body of evidence suggests the role of male hypogonadism as a possible harbinger for poor clinical outcomes across hospitalized Covid-19 patients. Accordingly, we sought to investigate the impact of dysregulated hypothalamic-pituitary-gonadal axis on the severity of the clinical manifestations for hospitalized Covid-19 patients matched with healthy controls through a systematic review and meta-analysis. Databases were searched from inception to March 2022. A standardized mean difference (SMD) meta-analysis focused on hospitalized Covid-19 patients and healthy controls was developed for studies who reported total testosterone (TT) and luteinizing hormone (LH) levels at hospital admission. Overall, n = 18 series with n = 1575 patients between 2020 and 2022 were reviewed. A significant decrease in SMD of TT levels in Covid-19 patients compared to paired controls was observed (- 3.25 nmol/L, 95%CI - 0.57 and - 5.93). This reduction was even more consistent when matching severe Covid-19 patients with controls (- 5.04 nmol/L, 95%CI - 1.26 and - 8.82) but similar for Covid-19 survivors and non-survivors (- 3.04 nmol/L, 95%CI - 2.04 and - 4.05). No significant variation was observed for serum LH levels across studies. Patient related comorbidities, year of the pandemic, and total lymphocyte count were associated with the observed estimates. TT levels may be a useful serum marker of poor outcomes among Covid-19 patients. These findings may support the development of ad-hoc clinical trials in the Covid-19 risk-group classification and subsequent disease monitoring. The interplay between TT and immune response should be evaluated in future researches.
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Affiliation(s)
- Stefano Salciccia
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy.
| | - Martina Moriconi
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Vittorio Canale
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Frank Glover
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Emory University School of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Federico Belladelli
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Nicolas Seranio
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Satvir Basran
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Ettore De Berardinis
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Giovanni Di Pierro
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Gian Piero Ricciuti
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Benjamin I Chung
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Alessandro Sciarra
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, 00161, Rome, Italy
- Department of Urology, Stanford University School of Medicine, Stanford, CA, 94305, USA
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15
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Lauritsen MP, Kristensen TL, Hansen CB, Schneider UV, Talbot AL, Skytte AB, Petersen JH, Johannsen TH, Zedeler A, Albrethsen J, Juul A, Priskorn L, Jørgensen N, Westh H, Freiesleben NLC, Nielsen HS. The impact of acute SARS-CoV-2 on testicular function including insulin-like factor 3 (INSL3) in men with mild COVID-19: A longitudinal study. Andrology 2024; 12:437-446. [PMID: 37421657 DOI: 10.1111/andr.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may affect the male reproductive system as it uses angiotensin-converting enzyme (ACE)2, which is expressed in testicular tissue, as an entry point into the cell. Few studies have evaluated the long-term effects of mild coronavirus disease 2019 (COVID-19) on testicular function, and insulin-like factor 3 (INSL3) levels have not previously been assessed during acute SARS-CoV-2 infection. OBJECTIVES The aim of the study was to assess the impact of acute SARS-CoV-2 infection on testicular function including INSL3 and the presence of SARS-CoV-2 RNA in semen in non-hospitalised men with mild COVID-19. MATERIALS AND METHODS This longitudinal study included 36 non-hospitalised SARS-CoV-2-positive men (median age 29 years). Inclusion was within seven days following a positive SARS-CoV-2 reverse-transcription polymerase chain reaction test. Reproductive hormone levels, semen parameters, and the presence of SARS-CoV-2 RNA in oropharyngeal and semen samples were assessed during acute SARS-CoV-2 infection (baseline) and at three- and six-month follow-up. Wilcoxon matched-pair signed-rank (two samples) test was used to assess time-related alterations in reproductive hormone levels and semen parameters. RESULTS Lower plasma testosterone (T) (total and calculated free (c-fT)) and higher luteinising hormone (LH) concentrations were observed during acute SARS-CoV-2 infection (baseline) compared to three- and six-month follow-up. Consequently, ratios of c-fT/LH were lower at baseline compared to three- and six-month follow-up (p < 0.001 and p = 0.003, respectively). Concomitantly, lower INSL3 concentrations were observed at baseline compared to three-month follow-up (p = 0.01). The total number of motile spermatozoa was also lower at baseline compared to six-month follow-up (p = 0.02). The alterations were detected irrespective of whether the men had experienced SARS-CoV-2-related fever episodes or not. No SARS-CoV-2 RNA was detected in semen at any time point. DISCUSSION AND CONCLUSION This study showed a reduction in testicular function, which was for the first time confirmed by INSL3, in men mildly affected by SARS-CoV-2 infection. The risk of transmission of SARS-CoV-2 RNA via semen seems to be low. Febrile episodes may impact testicular function, but a direct effect of SARS-CoV-2 cannot be excluded.
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Affiliation(s)
- Mette Petri Lauritsen
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Christine Bo Hansen
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Uffe Vest Schneider
- Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Anna Lando Talbot
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | | | | | - Trine Holm Johannsen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Zedeler
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Jakob Albrethsen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Juul
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Laerke Priskorn
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Westh
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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GamalEl Din SF, Nabil Ismail N, Kaddah A, Abdel Salam MA, Korani MS, Hamed MA. Effect of COVID-19 on sexual and reproductive functions of Egyptian males following recovery: A cross sectional study. Urologia 2024; 91:154-158. [PMID: 37334432 PMCID: PMC10277877 DOI: 10.1177/03915603231181723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/28/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION We aimed to assess the sexual and the reproductive functions in males post COVID-19 infection in Beni-Suef Governorate. METHODS One hundred men were recruited in the current study. All participants were assessed by the Arabic validated version of the International Index of the Erectile Function 5 (ArIIEF-5), semen analysis, and Hospital Depression and Anxiety Scale (HADS). Finally, morning testosterone serum level was measured. RESULTS There were significant decreases in the sperm total motility, the ArIIEF-5 score, and serum total testosterone in the post COVID-19 patients after 3 months when compared to the controls. However, there were significant increases in the sperm total motility, the ArIIEF-5 score, and serum total testosterone in the post COVID-19 patients after 6 months group when compared to the post COVID-19 patients after 3 months group. Moreover, there was a significant increase in the HADS score in the post COVID-19 patients after 3 months when compared to the controls. In contrast, there was a significant decrease in the HADS score in the post COVID-19 patients after 6 months when compared to the post COVID-19 patients after 3 months. CONCLUSION Our study had shown temporary impairment of sexual and reproductive functions in post COVID-19 convalescent males especially after 6 months from the onset of the infection.
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Affiliation(s)
- Sameh Fayek GamalEl Din
- Department of Andrology, Sexology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nashaat Nabil Ismail
- Department of Andrology, Sexology & STDs, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Amr Kaddah
- Department of Andrology, Sexology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Ahmed Abdel Salam
- Department of Andrology, Sexology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mahmoud Sayed Korani
- Department of Andrology, Sexology & STDs, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Mostafa Ahmed Hamed
- Department of Andrology, Sexology & STDs, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
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17
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Cani M, Epistolio S, Dazio G, Modesti M, Salfi G, Pedrani M, Isella L, Gillessen S, Vogl UM, Tortola L, Treglia G, Buttigliero C, Frattini M, Pereira Mestre R. Antiandrogens as Therapies for COVID-19: A Systematic Review. Cancers (Basel) 2024; 16:298. [PMID: 38254788 PMCID: PMC10814161 DOI: 10.3390/cancers16020298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In 2019, the breakthrough of the coronavirus 2 disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), represented one of the major issues of our recent history. Different drugs have been tested to rapidly find effective anti-viral treatments and, among these, antiandrogens have been suggested to play a role in mediating SARS-CoV-2 infection. Considering the high heterogeneity of studies on this topic, we decided to review the current literature. METHODS We performed a systematic review according to PRISMA guidelines. A search strategy was conducted on PUBMED and Medline. Only original articles published from March 2020 to 31 August 2023 investigating the possible protective role of antiandrogens were included. In vitro or preclinical studies and reports not in the English language were excluded. The main objective was to investigate how antiandrogens may interfere with COVID-19 outcomes. RESULTS Among 1755 records, we selected 31 studies, the majority of which consisted of retrospective clinical data collections and of randomized clinical trials during the first and second wave of the COVID-19 pandemic. CONCLUSIONS In conclusion, we can state that antiandrogens do not seem to protect individuals from SARS-CoV-2 infection and COVID-19 severity and, thus, their use should not be encouraged in this field.
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Affiliation(s)
- Massimiliano Cani
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy;
| | - Samantha Epistolio
- Laboratory of Genetics and Molecular Pathology, Institute of Pathology, Ente Ospedaliero Cantonale (EOC), 6600 Locarno, Switzerland (M.F.)
| | - Giulia Dazio
- Laboratory of Genetics and Molecular Pathology, Institute of Pathology, Ente Ospedaliero Cantonale (EOC), 6600 Locarno, Switzerland (M.F.)
| | - Mikol Modesti
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Giuseppe Salfi
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
- Institute of Oncology Research (IOR), 6500 Bellinzona, Switzerland
| | - Martino Pedrani
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy
| | - Luca Isella
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland;
| | - Ursula Maria Vogl
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
| | - Luigi Tortola
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
| | - Giorgio Treglia
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland;
- Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Consuelo Buttigliero
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy;
| | - Milo Frattini
- Laboratory of Genetics and Molecular Pathology, Institute of Pathology, Ente Ospedaliero Cantonale (EOC), 6600 Locarno, Switzerland (M.F.)
| | - Ricardo Pereira Mestre
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland (S.G.); (U.M.V.)
- Institute of Oncology Research (IOR), 6500 Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland;
- Clinical Research Unit, myDoctorAngel, 6934 Bioggio, Switzerland
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18
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Abdelaziz AS, Ghoneem AM. Delayed impacts of COVID-19 infection on unexplained male infertility: 2-year follow-up of normal sperm parameters in unexplained male infertility in KSA. Urol Ann 2024; 16:75-80. [PMID: 38415226 PMCID: PMC10896322 DOI: 10.4103/ua.ua_154_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/06/2023] [Accepted: 08/26/2023] [Indexed: 02/29/2024] Open
Abstract
Purpose The current study aimed to assess the long-term effect of COVID-19 infection on unexplained male infertility. Materials and Methods A retrospective comparative study of 134 men attending the infertility outpatient clinic of our institution before exposing to COVID-19 infection in KSA from January 2019 to July 2022. Medical recorded data of these patients who were investigated before COVID-19 infection were retrospectively collected using the hospital's electronic database, including semen analysis, sex hormonal, and ultrasound testicular size, and their data were compared prospectively to collected data after 2-year follow-up. Results One hundred and thirty-four infertile males who got COVID-19 infection in KSA (median age, 33 years) were assisted retrospectively preinfection and delayed 2 years postinfection (median of 23 months). Of the 134 men, 44 (32.83%) were asymptomatic positive COVID-19 (Group A), 68 (50.74%) had mild-to-moderate symptomatic positive COVID-19 (Group B), and 22 (16.41%) had severe symptomatic positive COVID-19 (Group C). There was no significant change between pre- and postinfections in sperm parameters, sex hormonal level, and testicular size. Subgroup analyses were performed for patients regarding the severity of infections. None of the evaluated parameters differed significantly after infections up to 2 years. Results of this study demonstrate that COVID-19 infection does not have significant changes in sperm parameters, sex hormonal level, and testicular size. Conclusion The long-term impact of COVID-19 infections has no significant effect on normal sperm parameters, sex hormones, and testicular size in male infertility in KSA.
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Affiliation(s)
- Alsayed Saad Abdelaziz
- Department of Urology, Faculty of Medicine, Al-Azhar University, Damietta, Cairo, Egypt
- Department of Urology, Al-Jedaani Hospital - Al-Safa, Saudi Arabia
| | - Ayman Mohammed Ghoneem
- Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Department of Urology, New Aljedany Hospital, Jeddah, Saudi Arabia
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19
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Prasad A, Rashmi KG, Sahoo J, Kamalanathan S, Wyawahare M, Anusuya R, Naik D. Male Hypogonadism After Recovery from Acute COVID-19 Infection: A Prospective Observational Study. Exp Clin Endocrinol Diabetes 2024; 132:23-32. [PMID: 38049105 DOI: 10.1055/a-2201-8816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 can affect the hypothalamic-pituitary-gonadal axis (HPG) due to the expression of the angiotensin-converting enzyme 2 receptor. OBJECTIVES To assess the prevalence of hypogonadism and Sertoli cell dysfunction in coronavirus disease 2019 (COVID-19) male survivors. METHOD Male subjects recovered from acute COVID-19 infection were prospectively observed. The primary outcomes included the proportion of hypogonadism, defined biochemically as serum testosterone<230 ng/dL or CFT of<6.4 ng/mL if the total testosterone is between 230-320 ng/m. Sertoli cell dysfunction was defined as inhibin-B level<54.5 pg/mL. Subjects with hypogonadism were followed up at 12 months to assess the recovery of the HPG axis. RESULTS Eighty-three subjects aged≥18 years were evaluated at a median of 120 (±35) days post-recovery. Their mean age was 49.50±12.73 years, and the mean BMI was 26.84±5.62 kg/m2. Low testosterone was detected in 21 (24.71%) and low inhibin-B was detected in 14 (19.71%) out of 71 subjects at 3 months. Subjects with low testosterone were younger, with a mean age of 43.29±12.03 years (P-0.08) and higher BMI (P-0.012). The severity of COVID-19 infection, duration of hospitalization, and other factors were not significantly associated with low testosterone. At 12 months, 18 out of 21 subjects came for follow-up, of which 9 (50%) showed persistently low testosterone, suggestive of hypogonadism. CONCLUSION Following COVID-19 infection, testosterone levels recovered over time; however, a significant proportion of subjects had low levels at 12-month follow-up. These findings have long-term implications for the management of COVID-19 subjects.
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Affiliation(s)
- Aravind Prasad
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K G Rashmi
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Mukta Wyawahare
- Department of Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Anusuya
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dukhabandhu Naik
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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20
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Stark J, Kuster SP, Hungerbühler V. Impact of COVID-19 disease on the male factor in reproductive medicine - how-to advise couples undergoing IVF/ICSI. Reprod Fertil Dev 2024; 36:RD23205. [PMID: 38185121 DOI: 10.1071/rd23205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
CONTEXT The COVID-19 pandemic has caused widespread concern about its potential impact on various aspects of human health. AIMS This narrative review aims to summarise the current knowledge about the impact of COVID-19 on sperm quality and its effect on assisted reproductive technology. METHODS In this narrative review, a literature search using the PubMed and MEDLINE databases was conducted to identify relevant original research articles published up to 29 January 2023. RESULTS Thirty original studies were included in our review. There is evidence that SARS-CoV-2 is detectable in seminal fluid during the acute phase of infection and for up to 1month. However, the fact that SARS-CoV-2 is barely detectable in semen makes sexual transmission very unlikely. COVID-19 infection has been associated with the following changes in sperm quality: morphology, altered motility, changed DNA fragmentation-index (DFI), decreased sperm concentration, lower total number of sperm, and a significant increase in leukocytes and cytokines. The effects mostly seem to be reversible and have not been shown to negatively affect the outcome of assisted reproductive technology but should lead to further research concerning the health of the offspring, because a correlation of increased DFI after COVID-19 even 5months after disease could be assumed. CONCLUSIONS The findings of this narrative review suggest that SARS-CoV-2 may harm sperm quality in the acute phase. IMPLICATIONS A recovery time of at least 3months regarding assisted reproductive therapy could be reasonable.
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Affiliation(s)
- Julia Stark
- Kantonsspital St. Gallen, Department of Gynecological Endocrinology and Reproductive Medicine, St. Gallen, Switzerland
| | - Stefan P Kuster
- Kantonsspital St. Gallen, Division of Infectious Diseases and Hospital Epidemiology, Rorschacher Str. 95, 9007 St. Gallen, Switzerland
| | - Vera Hungerbühler
- Kantonsspital St. Gallen, Department of Gynecological Endocrinology and Reproductive Medicine, Fiore Praxis AG, Brauerstrasse 95, 9016 St. Gallen, Switzerland
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21
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Kaur H, Chauhan A, Mascarenhas M. Does SARS Cov-2 infection affect the IVF outcome - A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 292:147-157. [PMID: 38006819 DOI: 10.1016/j.ejogrb.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
STUDY QUESTION What is the effect of SARS Cov-2 on IVF outcome? SUMMARY ANSWER Mild or asymptomatic Covid-19 infection does not appear to affect clinical or ongoing pregnancy rate after IVF. WHAT IS ALREADY KNOWN Covid-19 has been shown to affect female and male fertility and reproductive function. Studies have shown variable results regarding impact of Covid-19 on IVF outcome with few reporting impaired ovarian reserve, oocyte and embryo quality, semen parameters, clinical pregnancy rate (CPR) and live birth rate (LBR) while others reported no effect on IVF outcome. STUDY DESIGN, SIZE, DURATION An electronic database search of PubMed, EMBASE, SCOPUS, WHO Covid-19 database, Clinical trials.gov and Cochrane Central was performed for articles published in English language between 1st January 2020 and 15th October 2022 by two independent reviewers using predefined eligibility criteria We have included observational studies both prospective and retrospective, cohort studies, and case control studies and excluded narrative reviews, case studies, cost-effectiveness studies or diagnostic studies. Risk of bias was assessed using NOS and quality of evidence was graded by GRADE pro. PARTICIPANTS, SETTINGS, METHODS Studies comparing women undergoing IVF and comparing Covid-19 affected with those unaffected by Covid-19 were included. Also, studies comparing immune group (infected or vaccinated) in the study group and unaffected as controls (historical controls, IVF cycles done prior to Covid-19 outbreak but matched with study group) were included. Those with no comparison group or published in language other than English language or duplicate studies were excluded. MAIN RESULTS AND ROLE OF CHANCE We identified 5046 records and after full text screening of 82 studies, 12 studies were selected for final review. For the clinical pregnancy rate, there was no difference in the CPR in covid recovered or control patients (OR 0.90, 95 % CI = 0.67 to1.21; I2 = 29 %). Similarly, there was no significant effect on implantation rate (RR 0.92, 95 % CI = 0.68 to1.23; I2 = 31 %) and ongoing pregnancy rate (RR 0.96, 95 % CI = 0.79 to 1.15;I2 = 21 %). The mean number of the oocyte retrieved per patient was not significantly different in both the groups (mean difference 0.52, 95 % CI = -1.45 to 2.49; I2 = 75 %). The certainty of the evidence was low. LIMITATIONS The meta-analysis is based on observational studies each involving small number of participants. Few studies reported outcomes as per patient while others reported as per cycle, for uniformity we have reported outcomes as per cycle. Sample size in most of studies was small. WIDER IMPLICATIONS OF FINDINGS This systematic review has not shown any significant effect on the outcome of IVF cycles in patients post Covid-19 recovery compared to controls. But given the sample size, the findings should be considered with caution. REGISTRATION The review protocol has been registered on PROSPERO (registration number CRD42022314515).
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Affiliation(s)
- Harpreet Kaur
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh 174001, India.
| | - Anil Chauhan
- Evidence-Based Health Informatics Unit, Regional Resource Centre, Dept. of Telemedicine, Post Graduate Institute of Medical Education & Research Chandigarh, 160012, India
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22
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Ali AM, Abdlwahid RF, Ali KM, Mahmood KI, Rashid PMA, Rostam HM. The influence of SARS-CoV-2 on male reproduction and men's health. Eur J Clin Invest 2024; 54:e14097. [PMID: 37726940 DOI: 10.1111/eci.14097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/19/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND SARS-CoV-2, the virus responsible for COVID-19, primarily affects the respiratory system by targeting the Angiotensin-converting enzyme 2 (ACE2) receptor and TMPRSS2. However, these receptors are also present in other organs, including the testes, where a higher concentration of ACE2 receptors has been observed. This raises concerns about the potential impact of the virus on male fertility. AIMS In this study, we aimed to assess the effects of SARS-CoV-2 on semen parameters by comparing samples during and after infection in the same patients. MATERIALS & METHOD The study enrolled 51 individuals who had contracted COVID-19 and analysed various parameters related to sperm quality and quantity, including C-reactive protein, testosterone levels, total sperm concentration, motility and morphology. A comparison was made between these parameters during the initial infection with SARS-CoV-2 and after a 2- and 5-month recovery period. RESULTS The results indicated that all of the mentioned parameters were significantly affected during COVID-19 infection (PCR-ct, CRP, WBCs LH, FSH and testosterone levels, p-value = .0001). Furthermore, the study assessed TC, TM and sperm morphology in patients infected with SARS-CoV-2 and found that these parameters were also significantly influenced during the infection, (p-value = .0001; Morphology, p-value = .0004). We observed significant alterations in sperm count and morphology during infection, suggesting a potential negative impact on sperm quality. Additionally, lower hormone levels were observed during COVID-19 infection, possibly due to increased inflammatory cytokines. However, both hormones and inflammation markers returned to normal following recovery. Our findings indicate a statistically significant change in total sperm count, motility and morphology post-infection, which aligns with previous studies. Discussion, COVID-19 have a transient impact on sperm parameters and fertility, emphasizing the importance of further investigation into the long-term implications.
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Affiliation(s)
- Ayad M Ali
- Department of Chemistry, College of Science, University of Garmian, Kalar, Iraq
| | | | - Kameran M Ali
- Medical Lab Technology Department, Kalar Technical Institute, Garmian Polytechnic University, Kalar, Iraq
| | - Kochar I Mahmood
- Medical Laboratory Science Department, College of Science, Charmo University, Chamchamal, Iraq
| | - Peshnyar M A Rashid
- Medical Laboratory Science Department, Komar University of Science and Technology, Sulaimania, Iraq
- University of Halabja, Halabja, Iraq
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23
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Alvarez G, Molina M, Castilla JA, Clavero A, Gonzalvo MC, Sampedro A, Bernat N, Caba O. Study of SARS-CoV-2 in semen from asymptomatic donors with the presence of virus in nasopharyngeal swabs. Reprod Biomed Online 2023; 47:103321. [PMID: 37812975 DOI: 10.1016/j.rbmo.2023.103321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/10/2023] [Accepted: 07/25/2023] [Indexed: 10/11/2023]
Abstract
RESEARCH QUESTION Is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present in semen samples from asymptomatic donors who have positive virus results from nasopharyngeal swabs? DESIGN Nasopharyngeal PCR was performed on 1943 sperm donors between January 2021 and March 2022. The result was positive for 140 donations, and the presence of SARS-CoV-2 could be studied in cryopreserved semen from 84 of these donors. This included 67 participants in whom the quality of fresh semen could be compared with the previous donation, the day of the PCR-positive nasopharyngeal sampling and the first subsequent donation. Semen donations were cryopreserved following total semen (n = 26) or ready-to-use (n = 58) protocols. The presence of SARS-CoV-2 in cryopreserved samples was determined by reverse transcription PCR. Semen quality (volume, concentration and progressive motility) was evaluated in accordance with World Health Organization 2010 recommendations. RESULTS SARS-CoV-2 virus was not detected in any cryopreserved total semen or ready-to-use samples. No significant differences in semen volume, concentration or progressive motility were observed between the last previous donation, the day of the positive PCR nasopharyngeal sampling and the first subsequent donation. CONCLUSIONS The lack of detection of SARS-CoV-2 in semen samples from asymptomatic individuals infected with SARS-CoV-2 supports the safety of assisted human reproduction treatments using this type of sample.
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Affiliation(s)
- Gemma Alvarez
- Unidad de Gestión Clínica Laboratorios, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain
| | - Marta Molina
- Unidad de Gestión Clínica Laboratorios, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain; Unidad de Reproducción, Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
| | - José A Castilla
- Unidad de Gestión Clínica Laboratorios, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain; Unidad de Reproducción, Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Departamento de Anatomía y Embriología, Facultad de Medicina, Universidad de Granada, Granada, Spain; CEIFER Biobanco - GAMETIA, Granada, Spain
| | - Ana Clavero
- Unidad de Gestión Clínica Laboratorios, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain; Unidad de Reproducción, Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, Spain; Departamento de Anatomía y Embriología, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - María C Gonzalvo
- Unidad de Gestión Clínica Laboratorios, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain; Unidad de Reproducción, Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Sampedro
- Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain; Unidad de Gestión Clínica de Microbiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Nuria Bernat
- Unidad de Reproducción, Unidad de Gestión Clínica Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Octavio Caba
- Instituto de investigación biosanitaria ibs.GRANADA, Granada, Spain; Departamento de Anatomía y Embriología, Facultad de Medicina, Universidad de Granada, Granada, Spain; Instituto de Biopatología y Medicina Regenerativa (IBIMER), Centro de Investigación Biomédica (CIBM), Universidad de Granada, Granada, Spain
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24
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Yuan J, Zhou J, Zhang T, Ju X, Xu D. An online questionnaire survey on the sexual function of Chinese male adults in the COVID-19 pandemic with loosened controls. Prev Med Rep 2023; 36:102464. [PMID: 37854665 PMCID: PMC10580037 DOI: 10.1016/j.pmedr.2023.102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) may have a negative impact on the sexual health of male adults. An online questionnaire survey was conducted among male adults from February 04, 2023 to March 15, 2023 to analyze the impact of COVID-19 on the sexual health of male adults in China. Participants provided about their medical, social, lifestyle, and family situations information through questionnaires including the Brief Sexual Function Inventory (BSFI). Sexual function problems were defined based on predetermined cutoff values of the BSFI domain scores. A total of 1,250 male adults were included with median age as 32 years. According to the analysis of statistical results, sexual drive and erections firm enough to have sexual intercourse were reported to be present only a few days or less last month among 14.8 % and 11.1 % of COVID-19 survivors, respectively. Compared with uninfected persons, COVID-19 survivors had significantly lower scores on all BSFI domains and an increased risk of problems with sexual drive and erectile. In multivariate models of COVID-19 survivors, age ≥30 years, rural resident, lower education level, manual worker, lower income, and shorter duration from recovery to survey date were significantly associated with poorer overall sexual function. In this study, COVID-19 survivors was reported to have significantly poorer sexual function than uninfected persons. The COVID-19 may have had a significant impact on the sexual health of Chinese male adults. We need to focus on sexual dysfunction in COVID-19 survivors, and proactively provide effective interventions.
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Affiliation(s)
- Jixiang Yuan
- Urology Centre, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
- Institute of Surgery of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Jielong Zhou
- Urology Centre, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
- Institute of Surgery of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Tongtong Zhang
- Urology Centre, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
- Institute of Surgery of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Xiran Ju
- Urology Centre, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
- Institute of Surgery of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Dongliang Xu
- Urology Centre, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
- Institute of Surgery of Integrated Traditional Chinese and Western Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
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25
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Zeginiadou T, Symeonidis EN, Symeonidis A, Vakalopoulos I. SARS-CoV-2 infection (COVID-19) and male fertility: Something we should be worried about? Urologia 2023; 90:726-734. [PMID: 37278004 PMCID: PMC10247691 DOI: 10.1177/03915603231175941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/19/2023] [Indexed: 06/07/2023]
Abstract
As of 2021, roughly 5 million deaths were linked to SARS-CoV-2 infection based on World Health Organization estimates. The pandemic takes its staggering death toll, severely affecting the healthcare systems and leading to detrimental implications globally. While the severe impact on the respiratory system is well-established, the exact effect on male reproduction is still largely uncharted territory. When it comes to gender, men appear more vulnerable compared to women. Increasing evidence suggests that COVID-19 adversely affects spermatogenesis and hormonal balance in diverse ways. Semen parameters seem to be compromised at least temporarily, while long-term worsening needs to be clarified in studies with extended follow-up. For the time being, no data support the adverse effect of COVID-19 vaccines on a male's reproductive health. In the present article, we examine the available literature and briefly discuss the impact of the virus on reproduction and fertility. We further provide a comprehensive overview of the current status of vaccination and its potential effect on male fertility. Ultimately, we address the need for future well-designed large-scale trials before drawing definite conclusions on the exact impact of the virus on a male's fecundity.
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Affiliation(s)
| | - Evangelos N Symeonidis
- 1st Department of Urology, Aristotle University, “G. Gennimatas” General Hospital, Thessaloniki, Greece
| | - Asterios Symeonidis
- 1st Department of Urology, Aristotle University, “G. Gennimatas” General Hospital, Thessaloniki, Greece
| | - Ioannis Vakalopoulos
- 1st Department of Urology, Aristotle University, “G. Gennimatas” General Hospital, Thessaloniki, Greece
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26
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Mahé D, Bourgeau S, da Silva J, Schlederer J, Satie AP, Kuassivi N, Mathieu R, Guillou YM, Le Tortorec A, Guivel-Benhassine F, Schwartz O, Plotton I, Dejucq-Rainsford N. SARS-CoV-2 replicates in the human testis with slow kinetics and has no major deleterious effects ex vivo. J Virol 2023; 97:e0110423. [PMID: 37830818 PMCID: PMC10653996 DOI: 10.1128/jvi.01104-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/01/2023] [Indexed: 10/14/2023] Open
Abstract
IMPORTANCE SARS-CoV-2 is a new virus responsible for the Covid-19 pandemic. Although SARS-CoV-2 primarily affects the lungs, other organs are infected. Alterations of testosteronemia and spermatozoa motility in infected men have raised questions about testicular infection, along with high level in the testis of ACE2, the main receptor used by SARS-CoV-2 to enter host cells. Using an organotypic culture of human testis, we found that SARS-CoV-2 replicated with slow kinetics in the testis. The virus first targeted testosterone-producing Leydig cells and then germ-cell nursing Sertoli cells. After a peak followed by the upregulation of antiviral effectors, viral replication in the testis decreased and did not induce any major damage to the tissue. Altogether, our data show that SARS-CoV-2 replicates in the human testis to a limited extent and suggest that testicular damages in infected patients are more likely to result from systemic infection and inflammation than from viral replication in the testis.
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Affiliation(s)
- Dominique Mahé
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
| | - Salomé Bourgeau
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
- University of CAS, Beijing, China
- CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai CAS, Shanghai, China
| | - Janaina da Silva
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
| | - Julie Schlederer
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
| | - Anne-Pascale Satie
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
| | - Nadège Kuassivi
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
| | - Romain Mathieu
- Service d‘Urologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Yves-Marie Guillou
- Service de Coordination des prélèvements, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Anna Le Tortorec
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
| | | | - Olivier Schwartz
- Virus and Immunity Unit, Institut Pasteur, Université de Paris Cité, CNRS UMR3569, Paris, France
| | - Ingrid Plotton
- Institut National de la Santé et de la Recherche Médicale, Institut Cellules Souche et Cerveau (SBRI), UMR_S1208, Bron, France
| | - Nathalie Dejucq-Rainsford
- Institut National de la Santé et de la Recherche Médicale, Ecole des Hautes Etudes en Santé Publique, Institut de recherche en santé, environnement et travail, Université de Rennes, UMR_S1085, Rennes, France
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27
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Allameh F, Kazemi M, Ajorlou M, Soroush S, Narouie B, Fatemi A, Dadpour M. The Effect of SARS-Cov2 Infection on The Spermogram: A Prospective Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2023; 17:259-263. [PMID: 37577909 PMCID: PMC10439987 DOI: 10.22074/ijfs.2023.556335.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND During the Coronavirus disease 2019 (COVID-19) pandemic, there was always concern about damage to different organs of the body. In this study, we aimed to determine if coronavirus 2 (SARS-CoV-2) could influence the sperm parameters in inpatient adult men with COVID-19. MATERIALS AND METHODS In this prospective study during 2021, 22 patients with COVID-19 diagnosed with polymerase chain reaction (PCR) test and clinical symptoms and history of admission and 19 volunteer healthy men as the control group participated. They were asked to provide semen samples at 2 and 6 months after hospital discharge and the same time for the control group. The following parameters were measured in all semen samples and beside the demographic data, they compared between the two groups: volume (mL), sperm concentration (106/mL), total motile sperm percentage, progressive percentage, normal morphology percentage, and DNA fragmentation index (DFI). RESULTS The mean ± SD age of the participants in the COVID and control groups was 46.36 ± 9.94 and 45.84 ± 10.21 years, respectively (P=0.869). The mean ± SD body mass index (BMIs) of the participants in the COVID and control groups were 28.6 ± 5.460 and 29.6 ± 6.092, respectively (P=0.579). The mean ± SD number of children was 1.41 ± 1.054 in the COVID group and 1.47 ± 1.073 in the control group (P=0.847). All the sperm parameters were significantly impaired after 2 months in the COVID group in comparison with the control group (P<0.05). After 4 months from first sampling, all the parameters were improved significantly (except normal morphology) but had not yet reached the level of the control group. CONCLUSION SARS-CoV-2 affected semen parameters in patients admitted because of COVID-19, in the short term. It is expected that this will improve with time.
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Affiliation(s)
- Farzad Allameh
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Kazemi
- Infertility and IVF Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Ajorlou
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Soroush
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Narouie
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Fatemi
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehdi Dadpour
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Shahid Labbafinejad Hospital, Tehran, Iran.
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Muyayalo KP, Gong GS, Kiyonga Aimeé K, Liao AH. Impaired immune response against SARS-CoV-2 infection is the major factor indirectly altering reproductive function in COVID-19 patients: a narrative review. HUM FERTIL 2023; 26:778-796. [PMID: 37811836 DOI: 10.1080/14647273.2023.2262757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/25/2023] [Indexed: 10/10/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease affecting multiple systems and organs, including the reproductive system. SARS-CoV-2, the virus that causes COVID-19, can damage reproductive organs through direct (angiotensin converting enzyme-2, ACE-2) and indirect mechanisms. The immune system plays an essential role in the homeostasis and function of the male and female reproductive systems. Therefore, an altered immune response related to infectious and inflammatory diseases can affect reproductive function and fertility in both males and females. This narrative review discussed the dysregulation of innate and adaptive systems induced by SARS-CoV-2 infection. We reviewed the evidence showing that this altered immune response in COVID-19 patients is the major indirect mechanism leading to adverse reproduction outcomes in these patients. We summarized studies reporting the long-term effect of SARS-CoV-2 infection on women's reproductive function and proposed the chronic inflammation and chronic autoimmunity characterizing long COVID as potential underlying mechanisms. Further studies are needed to clarify the role of autoimmunity and chronic inflammation (long COVID) in altered female reproduction function in COVID-19.
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Affiliation(s)
- Kahindo P Muyayalo
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
- Department of Obstetrics and Gynecology, University of Kinshasa, Kinshasa, D. R. Congo
| | - Guang-Shun Gong
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Kahindo Kiyonga Aimeé
- Department of Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan, People's Republic of China
- Department of Tropical Medicine Infectious and Parasitic Diseases, University of Kinshasa, Kinshasa, D. R. Congo
| | - Ai-Hua Liao
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
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Shi S, Hu H, Wang J, Huang X, Li J, Li D. Evaluation of semen DNA integrity and related parameters with COVID-19 infection: a prospective cohort study. Virol J 2023; 20:218. [PMID: 37770916 PMCID: PMC10540357 DOI: 10.1186/s12985-023-02192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/22/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND In the context of Corona Virus Disease 2019 (COVID-19) global pandemic, Its impact on male reproductive function should be concerned. METHODS Our study is a prospective cohort study that recruited participants infected or uninfected with COVID-19 between December 2022 and March 2023. All laboratory tests and questionnaire data were completed at the First Affiliated Hospital of Nanchang University. A total of 132 participants were enrolled, with 78 COVID-19 positive patients as the positive group and 54 COVID-19 negative participants as the negative group. Semen quality was assessed by the fifth World Health Organization criteria. The general characteristics of semen samples were assessed using CASA (computer-assisted sperm analysis). DNA damage and the high density stainability was assessed by sperm chromatin structure analysis (SCSA) based on flowcytometry. RESULTS The sperm concentration, progressive motility and motility in COVID-19 negative group were significantly higher than positive group. In the following DNA damage analysis, a remarkably lower sperm DNA fragmentation index (DFI) in the COVID-19 negative group. In the positive group, unhealthy lifestyles had no significant effect on semen parameters, DNA fragmentation and nuclear compaction. CONCLUSIONS After excluding the interference of unhealthy lifestyle, the COVID-19 infection can have a significant impact on the quality of semen, especially the DFI,. Therefore, it shows that COVID-19 can adversely affects male fertility, and this result provides advisory guidance for clinicians.
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Affiliation(s)
- Shuibo Shi
- Department of Assisted Reproduction, the First Affiliated Hospital of Nanchang University, Yongwai Street 17, Nanchang City, Jiangxi Province, China
| | - Hongji Hu
- Department of Assisted Reproduction, the First Affiliated Hospital of Nanchang University, Yongwai Street 17, Nanchang City, Jiangxi Province, China
| | - Jiayao Wang
- Department of Assisted Reproduction, the First Affiliated Hospital of Nanchang University, Yongwai Street 17, Nanchang City, Jiangxi Province, China
| | - Xueming Huang
- Department of Clinical Laboratory, the First Affiliated Hospital of Nanchang University, Yongwai Street 17, Nanchang City, Jiangxi Province, China
| | - Jianhao Li
- Department of Assisted Reproduction, the First Affiliated Hospital of Nanchang University, Yongwai Street 17, Nanchang City, Jiangxi Province, China
| | - Dongshui Li
- Department of Assisted Reproduction, the First Affiliated Hospital of Nanchang University, Yongwai Street 17, Nanchang City, Jiangxi Province, China.
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30
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Paira DA, Beltramone F, Olmedo JJ, Tissera AD, Molina RI, Fux-Otta C, Olivera C, Motrich RD. Persistent oligonecrozoospermia after asymptomatic SARS-CoV-2 infection. A case report and literature review. Heliyon 2023; 9:e20340. [PMID: 37809541 PMCID: PMC10560057 DOI: 10.1016/j.heliyon.2023.e20340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
COVID-19 is known to have deleterious effects on different systems such as the respiratory, cardiovascular, central nervous, and gastrointestinal. However, conflicting data about the possible implications for male reproductive health and fertility have been reported. In addition, the long-term consequences of SARS-CoV-2 infection remain unclear. Herein, we report a case of a 42-year-old man with no known co-morbidities and normal baseline semen quality, who subsequently suffered an asymptomatic SARS-CoV-2 infection. Shortly after, the patient developed sudden oligoasthenozoospermia, even reaching azoospermia, which gradually evolved into persistent severe oligonecrozoospermia, accompanied by semen inflammation and oxidative stress. Remarkably, the latter occurred in the absence of urogenital infections, hormonal imbalances, tissue/organ obstruction/damage, medication or drug treatment, smoking, or exposure to toxins/pollutants, radiation, or high temperature. This case constitutes valuable clinical evidence that adds to the current knowledge in the field and highlights the need for further and longer follow-up studies to better understand the putative long-term consequences of SARS-CoV-2 infection on male fertility.
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Affiliation(s)
- Daniela Andrea Paira
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Fernando Beltramone
- OVUM- Centro de Medicina Reproductive, Fetal y Cirugía Ambulatoria, Córdoba, Argentina
| | - José Javier Olmedo
- Fundación Urológica Córdoba para la Docencia e Investigación Médica (FUCDIM), Córdoba, Argentina
| | | | | | - Carolina Fux-Otta
- Hospital Universitario de Maternidad y Neonatología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | - Carolina Olivera
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ruben Dario Motrich
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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Cakir C, Kuspinar G, Kurt G, Berber M, Aslan K, Kasapoglu I, Uncu G, Avcı B. Comparison of semen parameters in the same patients before and after diagnosis of COVID-19. J Med Virol 2023; 95:e29094. [PMID: 37695129 DOI: 10.1002/jmv.29094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
Clinical and histopathological evidence suggest that the male reproductive system may be negatively impacted in patients with coronavirus disease (COVID-19). The objective of this study is to investigate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on semen parameters by comparing semen analyses before and after COVID-19 diagnosis in the same patient. We retrospectively analyzed 342 semen analyses by reviewing medical records. The study included two groups of patients: (i) those who underwent two consecutive semen analyses within 6 months, one before (n = 114) and one after (n = 114) COVID-19 diagnosis, and (ii) a control group (n = 114) that was age-matched and did not receive a diagnosis of COVID-19. The study results indicated a significant decrease in semen volume, total sperm count per ejaculate, progressive motile sperm count, total motile sperm count, and normal sperm morphology after SARS-CoV-2 infection in comparison to their respective values before the infection. Subgroup analyses showed that the duration of COVID-19 diagnosis (short-term vs. long-term) did not impact the changes in semen parameters. However, fever during the COVID-19 process had a negative effect on semen parameters, particularly sperm concentration, unlike in patients without fever. In conclusion, our findings suggest that SARS-CoV-2 infection is associated with a decline in semen quality, which may potentially impact male fertility. Furthermore, it's important to note that the negative effects on semen parameters may persist in the long-term. Our results also indicate that fever during active infection could be a significant risk factor that negatively affects spermatogenesis.
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Affiliation(s)
- Cihan Cakir
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Goktan Kuspinar
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Gizem Kurt
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Miray Berber
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Kiper Aslan
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Isil Kasapoglu
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Gurkan Uncu
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Berrin Avcı
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
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32
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Dai P, Qiao F, Chen Y, Chan DYL, Yim HCH, Fok KL, Chen H. SARS-CoV-2 and male infertility: from short- to long-term impacts. J Endocrinol Invest 2023; 46:1491-1507. [PMID: 36917421 PMCID: PMC10013302 DOI: 10.1007/s40618-023-02055-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE The coronavirus 2019 (COVID-19) pandemic-caused by a new type of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-has posed severe impacts on public health worldwide and has resulted in a total of > 6 million deaths. Notably, male patients developed more complications and had mortality rates ~ 77% higher than those of female patients. The extensive expression of the SARS-CoV-2 receptor and related proteins in the male reproductive tract and the association of serum testosterone levels with viral entry and infection have brought attention to COVID-19's effects on male fertility. METHODS The peer-reviewed articles and reviews were obtained by searching for the keywords SARS-CoV-2, COVID-19, endocrine, spermatogenesis, epididymis, prostate, and vaccine in the databases of PubMed, Web of Science and Google Scholar from 2020-2022. RESULTS This review summarizes the effects of COVID-19 on the male reproductive system and investigates the impact of various types of SARS-CoV-2 vaccines on male reproductive health. We also present the underlying mechanisms by which SARS-CoV-2 affects male reproduction and discuss the potentially harmful effects of asymptomatic infections, as well as the long-term impact of COVID-19 on male reproductive health. CONCLUSION COVID-19 disrupted the HPG axis, which had negative impacts on spermatogenesis and the epididymis, albeit further investigations need to be performed. The development of vaccines against various SARS-CoV-2 variations is important to lower infection rates and long-term COVID risks.
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Affiliation(s)
- P Dai
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China
| | - F Qiao
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China
| | - Y Chen
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China
| | - D Y L Chan
- Assisted Reproductive Technologies Unit, Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - H C H Yim
- Microbiome Research Centre, School of Clinical Medicine, Faculty of Medicine, St George and Sutherland Campus, UNSW Sydney, Sydney, Australia
| | - K L Fok
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
- Kong Joint Laboratory for Reproductive Medicine, Sichuan University-The Chinese University of Hong, West China Second University Hospital, Chengdu, People's Republic of China.
| | - H Chen
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China.
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Parihar A, Malviya S, Khan R, Kaushik A, Mostafavi E. COVID-19 associated thyroid dysfunction and other comorbidities and its management using phytochemical-based therapeutics: a natural way. Biosci Rep 2023; 43:BSR20230293. [PMID: 37212057 PMCID: PMC10372472 DOI: 10.1042/bsr20230293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/23/2023] Open
Abstract
The present severe acute respiratory syndrome-2 (SARS-CoV-2) mediated Coronavirus pandemic (COVID-19) and post-COVID-19 complications affect human life drastically. Patients who have been cured of COVID-19 infection are now experiencing post-COVID-19 associated comorbidities, which have increased mortality rates. The SARS-CoV-2 infection distresses the lungs, kidneys, gastrointestinal tract, and various endocrine glands, including the thyroid. The emergence of variants which includes Omicron (B.1.1.529) and its lineages threaten the world severely. Among different therapeutic approaches, phytochemical-based therapeutics are not only cost-effective but also have lesser side effects. Recently a plethora of studies have shown the therapeutic efficacy of various phytochemicals for the treatment of COVID-19. Besides this, various phytochemicals have been found efficacious in treating several inflammatory diseases, including thyroid-related anomalies. The method of the phytochemical formulation is quick and facile and the raw materials for such herbal preparations are approved worldwide for human use against certain disease conditions. Owing to the advantages of phytochemicals, this review primarily discusses the COVID-19-related thyroid dysfunction and the role of key phytochemicals to deal with thyroid anomaly and post-COVID-19 complications. Further, this review shed light on the mechanism via which COVID-19 and its related complication affect organ function of the body, along with the mechanistic insight into the way by which phytochemicals could help to cure post-COVID-19 complications in thyroid patients. Considering the advantages offered by phytochemicals as a safer and cost-effective medication they can be potentially used to combat COVID-19-associated comorbidities.
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Affiliation(s)
- Arpana Parihar
- Industrial Waste Utilization, Nano and Biomaterials, CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, MP, India
| | - Shivani Malviya
- Department of Biochemistry and Genetics, Barkatullah University, Habib Ganj, Bhopal, Madhya Pradesh 462026, India
| | - Raju Khan
- Industrial Waste Utilization, Nano and Biomaterials, CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road, Bhopal 462026, MP, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Ajeet Kaushik
- NanoBioTech Laboratory, Department of Environmental Engineering, Florida Polytechnic University, Lakeland, FL 33805, U.S.A
- School of Engineering, University of Petroleum and Energy Studies, Dehradun 248007, India
| | - Ebrahim Mostafavi
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, U.S.A
- Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, U.S.A
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Kalfas T, Kaltsas A, Symeonidis EN, Symeonidis A, Zikopoulos A, Moustakli E, Tsiampali C, Tsampoukas G, Palapela N, Zachariou A, Sofikitis N, Dimitriadis F. COVID-19 and Male Infertility: Is There a Role for Antioxidants? Antioxidants (Basel) 2023; 12:1483. [PMID: 37627478 PMCID: PMC10451649 DOI: 10.3390/antiox12081483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/14/2023] [Accepted: 07/22/2023] [Indexed: 08/27/2023] Open
Abstract
Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), jeopardizes male fertility because of the vulnerability of the male reproductive system, especially the testes. This study evaluates the effects of the virus on testicular function and examines the potential role of antioxidants in mitigating the damage caused by oxidative stress (OS). A comprehensive PubMed search examined exocrine and endocrine testicular function alteration, the interplay between OS and COVID-19-induced defects, and the potential benefit of antioxidants. Although the virus is rarely directly detectable in sperm and testicular tissue, semen quality and hormonal balance are affected in patients, with some changes persisting throughout a spermatogenesis cycle. Testicular pathology in deceased patients shows defects in spermatogenesis, vascular changes, and inflammation. Acute primary hypogonadism is observed mainly in severely infected cases. Elevated OS and sperm DNA fragmentation markers suggest redox imbalance as a possible mechanism behind the fertility changes. COVID-19 vaccines appear to be safe for male fertility, but the efficacy of antioxidants to improve sperm quality after infection remains unproven due to limited research. Given the limited and inconclusive evidence, careful evaluation of men recovering from COVID-19 seeking fertility improvement is strongly recommended.
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Affiliation(s)
| | - Aris Kaltsas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Evangelos N. Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (A.S.)
| | - Asterios Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (A.S.)
| | - Athanasios Zikopoulos
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Efthalia Moustakli
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | | | - Georgios Tsampoukas
- Department of Urology, Oxford University Hospital NHS Trust, Oxford OX3 7LE, UK;
| | - Natalia Palapela
- Medical Faculty, Medical University of Sofia, 1431 Sofia, Bulgaria;
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (E.M.); (A.Z.); (N.S.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.N.S.); (A.S.)
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Kloping YP, Hidayatullah F, Rahman ZA, Chung E, Hakim L. Male Reproductive Tract Involvement and Sperm Parameters in SARS-CoV-2 Patients: A Systematic Review and Meta-Analysis. World J Mens Health 2023; 41:538-557. [PMID: 36102101 PMCID: PMC10307665 DOI: 10.5534/wjmh.220019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/06/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2023] Open
Abstract
PURPOSE There is a growing concern regarding the impact of SARS-CoV-2 infection on the male reproductive tract due to ACE2 receptor expression, however, its impact remains unclear. We performed this review to evaluate whether SARS-CoV-2 infection affects the male reproductive system. MATERIALS AND METHODS We conducted a search in the Embase, Scopus, and MEDLINE databases, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Eligible studies comprised articles reporting viral RNA presence in semen, sperm parameters, and orchitis or orchiepididymitis occurrence in SARS-CoV-2 patients. Observational studies' quality was determined using the Newcastle-Ottawa Scale (NOS). Case reports were assessed using the Joanna Briggs Institute (JBI)'s checklist. RESULTS A total of 32 relevant articles were included. Viral RNA was found in 7% of infected patients' semen (95% CI, -0.01 to 0.15) from 3 studies. There were also only 7% of patients with orchitis or orchiepididymitis clinical manifestations (95% CI, 0.05-0.10). The semen volume and concentration were 2.34 mL (95% CI, 1.87-2.81) and 51.73 million/mL (95% CI, 31.60-71.85). The progressive and total motility percentages were 36.11% (95% CI, 28.87-43.35) and 43.07% (95% CI, 28.57-57.57), respectively. The morphology was 6.03% (95% CI, -1.05 to 13.10). There is a difference in semen volume between moderate and severe infections (MD, 0.52; 95% CI, 0.27-0.76; p<0.0001) and concentration between mild and moderate (MD, 18.74; 95% CI, 1.02-36.46; p=0.04), mild and severe (MD, 43.50; 95% CI, 13.86-73.14; p=0.004), as well as moderate and severe (MD, 22.25; 95% CI, 9.33-35.17; p=0.0007). CONCLUSIONS SARS-CoV-2 infection may result in decreased sperm concentration in severe cases and the mechanism relates to potential reproductive tract inflammation. The absence of large viral RNA detection in the semen indicates a systemic effect, although this is largely unproven.
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Affiliation(s)
- Yudhistira Pradnyan Kloping
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Furqan Hidayatullah
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Zakaria Aulia Rahman
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Universitas Airlangga Teaching Hospital, Surabaya, East Java, Indonesia.
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Steenblock C, Toepfner N, Beuschlein F, Perakakis N, Mohan Anjana R, Mohan V, Mahapatra NR, Bornstein SR. SARS-CoV-2 infection and its effects on the endocrine system. Best Pract Res Clin Endocrinol Metab 2023; 37:101761. [PMID: 36907787 PMCID: PMC9985546 DOI: 10.1016/j.beem.2023.101761] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing corona virus disease 2019 (COVID-19) can infect multiple tissues, including endocrine organs, such as the pancreas, adrenal, thyroid, and adipose tissue. The main receptor for SARS-CoV-2, ACE2, is ubiquitously expressed in the cells of the endocrine organs and accordingly, the virus has been detected in various amounts in all endocrine tissues in post-mortem samples from COVID-19 patients. The infection with SARS-CoV-2 may directly lead to organ damage or dysfunction, such as hyperglycaemia or in rare cases, new-onset diabetes. Furthermore, an infection with SARS-CoV-2 may have indirect effects affecting the endocrine system. The exact mechanisms are not yet completely understood and have to be further investigated. Conversely, endocrine diseases may affect the severity of COVID-19 and emphasis has to be laid on reducing the prevalence, or enhance the treatment, of these often non-communicable diseases in the future.
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Affiliation(s)
- Charlotte Steenblock
- Department of Internal Medicine III, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Nicole Toepfner
- Department of Pediatrics, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - Nikolaos Perakakis
- Department of Internal Medicine III, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Nitish R Mahapatra
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, India
| | - Stefan R Bornstein
- Department of Internal Medicine III, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Nori W, Akeel Salman D. Seminal fluid changes in the COVID-19 era: During infection and Post-vaccination. GYNECOLOGY AND OBSTETRICS CLINICAL MEDICINE 2023; 3:88-93. [PMID: 38620126 PMCID: PMC10133885 DOI: 10.1016/j.gocm.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/07/2023] [Accepted: 04/21/2023] [Indexed: 04/17/2024]
Abstract
Coronavirus disease 2019 (COVID-19) predilection for angiotensin-converting enzyme 2 (ACE2) receptors allows its entrance and replication; however, they are not biochemically required for viral fusion into the cell membrane. Testicular tissue has abundant ACE2 receptors, making it a target for the COVID-19 virus. Seminal fluid parameters are measures of male fertility. Changes in semen parameters have been caused by coronavirus disease and vaccines. Some attribute that effect to direct hematogenic spread to the testis; others propose that the excessive immunological response triggered by the infection causes a deleterious effect. An unsubstantiated claim questioned whether the SARS-CoV-2 vaccine could trigger an unintentional immunological response that would impair male fertility once receiving the vaccine. Extensive research confirms the transient nature of those changes that affect sperm motility and count with full recovery post-COVID-19 infection and after vaccination. The vaccine's safety was reaffirmed; however, there are currently no recommendations for screening sperm donors. Research is warranted to guarantee the safety of couples undergoing assisted reproduction.
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Affiliation(s)
- Wassan Nori
- Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad, Iraq
| | - Dina Akeel Salman
- Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad, Iraq
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Hosseini E, Kohan-Ghadr HR, Bazrafkan M, Amorim CA, Askari M, Zakeri A, Mousavi SN, Kafaeinezhad R, Afradiasbagharani P, Esfandyari S, Nazari M. Rescuing fertility during COVID-19 infection: exploring potential pharmacological and natural therapeutic approaches for comorbidity, by focusing on NLRP3 inflammasome mechanism. J Assist Reprod Genet 2023; 40:1173-1185. [PMID: 36892705 PMCID: PMC9995769 DOI: 10.1007/s10815-023-02768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/28/2023] [Indexed: 03/10/2023] Open
Abstract
The respiratory system was primarily considered the only organ affected by Coronavirus disease 2019 (COVID-19). As the pandemic continues, there is an increasing concern from the scientific community about the future effects of the virus on male and female reproductive organs, infertility, and, most significantly, its impact on the future generation. The general presumption is that if the primary clinical symptoms of COVID-19 are not controlled, we will face several challenges, including compromised infertility, infection-exposed cryopreserved germ cells or embryos, and health complications in future generations, likely connected to the COVID-19 infections of parents and ancestors. In this review article, we dedicatedly studied severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) virology, its receptors, and the effect of the virus to induce the activation of inflammasome as the main arm of the innate immune response. Among inflammasomes, nucleotide oligomerization domain-like receptor protein, pyrin domain containing 3 (NLRP3) inflammasome pathway activation is partly responsible for the inflicted damages in both COVID-19 infection and some reproductive disorders, so the main focus of the discussion is on NLRP3 inflammasome in the pathogenesis of COVID-19 infection alongside in the reproductive biology. In addition, the potential effects of the virus on male and female gonad functions were discussed, and we further explored the potential natural and pharmacological therapeutic approaches for comorbidity via NLRP3 inflammasome neutralization to develop a hypothesis for averting the long-term repercussions of COVID-19. Since activation of the NLRP3 inflammasome pathway contributes to the damage caused by COVID-19 infection and some reproductive disorders, NLRP3 inflammasome inhibitors have a great potential to be considered candidates for alleviating the pathological effects of the COVID-19 infection on the germ cells and reproductive tissues. This would impede the subsequent massive wave of infertility that may threaten the patients.
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Affiliation(s)
- Elham Hosseini
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
- Department of Obstetrics and Gynecology, Mousavi Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hamid-Reza Kohan-Ghadr
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI USA
| | - Mahshid Bazrafkan
- Reproductive Biotechnology Research Center, Avicenna Research Institute (ARI), ACECR, Tehran, Iran
| | - Christiani A. Amorim
- Pôle de Recherche en Physiopathologie de la Reproduction, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Maryam Askari
- Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Armin Zakeri
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyedeh Neda Mousavi
- Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Raheleh Kafaeinezhad
- Department of Biology, Faculty of Basic Sciences, University of Maragheh, Maragheh, Iran
| | | | - Sahar Esfandyari
- Department of Urology, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Mahboobeh Nazari
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
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Leng T, Guo Z, Sang Z, Xin Q, Chen F. Effect of COVID-19 on sperm parameters: pathologic alterations and underlying mechanisms. J Assist Reprod Genet 2023:10.1007/s10815-023-02795-y. [PMID: 37115332 PMCID: PMC10140716 DOI: 10.1007/s10815-023-02795-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
The rapid outbreak of the coronavirus disease 2019 (COVID-19) pandemic has brought challenges to different medical fields, especially reproductive health. To date, most studies on the effects of COVID-19 on male reproduction have some limitations. In addition, there is little research on the mechanisms underlying by which severe acute respiratory syndrome coronavirus 2 infection affects semen quality. Here, we revealed the possible impact of COVID-19 on sperm parameters and the potential mechanisms. At present, it is still controversial whether COVID-19-induced fever adversely affects sperm parameters. Severe acute respiratory syndrome coronavirus 2 can induce up-regulation of pro-inflammatory cytokine, which leads to the destruction of blood-testis barrier and impairment of spermatogenesis. Moreover, severe viral infection of the respiratory system could induce systemic oxidative stress. Sperm are highly vulnerable to it due to their limited levels of antioxidant defense, unsophisticated DNA damage detection and repair mechanisms. Our review prompt medical staff and patients to consciously check the reproductive function of COVID-19 male patients. Moreover, opening our prospective beyond the direct infection could be the key to better understand the COVID-19 short and long-term effects and provide a new idea for future treatment of patients with reproductive function injury.
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Affiliation(s)
- Taiyang Leng
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Zhihui Guo
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Ziling Sang
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Qing Xin
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China.
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Wang S, Zhang A, Pan Y, Liu L, Niu S, Zhang F, Liu X. Association between COVID-19 and Male Fertility: Systematic Review and Meta-Analysis of Observational Studies. World J Mens Health 2023; 41:311-329. [PMID: 36326165 PMCID: PMC10042646 DOI: 10.5534/wjmh.220091] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Whether COVID-19 reduces male fertility remains requires further investigation. This meta-analysis and systematic review evaluated the impact of COVID-19 on male fertility. MATERIALS AND METHODS The literature in PubMed, Embase, MEDLINE, Web of Science, and Cochrane Library up to January 01, 2022 was systematically searched, and a meta-analysis was conducted to investigate the effect of COVID-19 on male fertility. Totally 17 studies with a total of 1,627 patients and 1,535 control subjects were included in our meta-analysis. RESULTS Regarding sperm quality, COVID-19 decreased the total sperm count (p=0.012), sperm concentration (p=0.001), total motility (p=0.001), progressive sperm motility (p=0.048), and viability (p=0.031). Subgroup analyses showed that different control group populations did not change the results. It was found that during the illness stage of COVID-19, semen volume decreased, and during the recovery stage of COVID-19, sperm concentration and total motility decreased <90 days. We found that sperm concentration and total motility decreased during recovery for ≥90 days. Fever because of COVID-19 significantly reduced sperm concentration and progressive sperm motility, and COVID-19 without fever ≥90 days, the sperm total motility and progressive sperm motility decreased. Regarding disease severity, the moderate type of COVID-19 significantly reduced sperm total motility, but not the mild type. Regarding sex hormones, COVID-19 increased prolactin and estradiol. Subgroup analyses showed that during the illness stage, COVID-19 decreased testosterone (T) levels and increased luteinizing hormone levels. A potential publication bias may have existed in our meta-analysis. CONCLUSIONS COVID-19 in men significantly reduced sperm quality and caused sex hormone disruption. COVID-19 had long-term effects on sperm quality, especially on sperm concentration and total motility. It is critical to conduct larger multicenter studies to determine the consequences of COVID-19 on male fertility.
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Affiliation(s)
- Shangren Wang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Aiqiao Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yang Pan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shuai Niu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fujun Zhang
- Department of Neonatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Neonatology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
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Lott N, Gebhard CE, Bengs S, Haider A, Kuster GM, Regitz-Zagrosek V, Gebhard C. Sex hormones in SARS-CoV-2 susceptibility: key players or confounders? Nat Rev Endocrinol 2023; 19:217-231. [PMID: 36494595 PMCID: PMC9734735 DOI: 10.1038/s41574-022-00780-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 12/14/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a clear sex disparity in clinical outcomes. Hence, the interaction between sex hormones, virus entry receptors and immune responses has attracted major interest as a target for the prevention and treatment of SARS-CoV-2 infections. This Review summarizes the current understanding of the roles of androgens, oestrogens and progesterone in the regulation of virus entry receptors and disease progression of coronavirus disease 2019 (COVID-19) as well as their therapeutic value. Although many experimental and clinical studies have analysed potential mechanisms by which female sex hormones might provide protection against SARS-CoV-2 infectivity, there is currently no clear evidence for a sex-specific expression of virus entry receptors. In addition, reports describing an influence of oestrogen, progesterone and androgens on the course of COVID-19 vary widely. Current data also do not support the administration of oestradiol in COVID-19. The conflicting evidence and lack of consensus results from a paucity of mechanistic studies and clinical trials reporting sex-disaggregated data. Further, the influence of variables beyond biological factors (sex), such as sociocultural factors (gender), on COVID-19 manifestations has not been investigated. Future research will have to fill this knowledge gap as the influence of sex and gender on COVID-19 will be essential to understanding and managing the long-term consequences of this pandemic.
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Affiliation(s)
- Nicola Lott
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | | | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - Ahmed Haider
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Gabriela M Kuster
- Department of Cardiology and Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland
| | - Vera Regitz-Zagrosek
- Charité, Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
- Department of Cardiology, Inselspital Bern University Hospital, Bern, Switzerland.
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Ata B, Vermeulen N, Mocanu E, Gianaroli L, Lundin K, Rautakallio-Hokkanen S, Tapanainen JS, Veiga A. SARS-CoV-2, fertility and assisted reproduction. Hum Reprod Update 2023; 29:177-196. [PMID: 36374645 PMCID: PMC9976972 DOI: 10.1093/humupd/dmac037] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge of the virus and its transmission has become available, allowing ART activities to resume. Still, questions on the impact of the virus on human gametes and fertility remain. OBJECTIVE AND RATIONALE This article summarizes published data, aiming to clarify the impact of SARS-CoV-2 and the COVID-19 disease on human fertility and assisted reproduction, as well as the impact of vaccination, and from this, provide answers to questions that are relevant for people contemplating pregnancy and for health care professionals. SEARCH METHODS PUBMED/MEDLINE and the WHO COVID-19 database were searched from inception to 5 October 2022 with search terms focusing on 'SARS-CoV-2' and gametes, embryos, reproductive function, fertility and ART. Non-English studies and papers published prior to 2020 were excluded, as well as reviews and non-peer reviewed publications. Full papers were assessed for relevance and quality, where feasible. OUTCOMES From the 148 papers included, the following observations were made. The SARS-CoV-2-binding proteins, angiotensin-converting enzyme 2 (ACE2) and type II transmembrane serine protease (TMPRSS2), are expressed in the testis, but co-expression remains to be proven. There is some evidence of SARS-CoV-2 RNA in the ejaculate of COVID-19 patients with severe disease, but not in those with mild/moderate disease. SARS-CoV-2 infection can impair spermatogenesis, but this seems to resolve after one spermatogenic cycle. Testosterone levels seem to be lower during and after COVID-19, but long-term data are lacking; disease severity may be associated with testosterone levels. COVID-19 cannot be considered a sexually transmitted disease. There is no co-expression of ACE2 and TMPRSS2 in the myometrium, uterus, ovaries or fallopian tubes. Oocytes seem to have the receptors and protease machinery to be susceptible to SARS-CoV-2 infection; however, viral RNA in oocytes has not been detected so far. Women contemplating pregnancy following COVID-19 may benefit from screening for thyroid dysfunction. There is a possible (transient) impact of COVID-19 on menstrual patterns. Embryos, and particularly late blastocysts, seem to have the machinery to be susceptible to SARS-CoV-2 infection. Most studies have not reported a significant impact of COVID-19 on ovarian reserve, ovarian function or follicular fluid parameters. Previous asymptomatic or mild SARS-CoV-2 infection in females does not seem to negatively affect laboratory and clinical outcomes of ART. There are no data on the minimum required interval, if any, between COVID-19 recovery and ART. There is no evidence of a negative effect of SARS-CoV-2 vaccination on semen parameters or spermatogenesis, ovarian function, ovarian reserve or folliculogenesis. A transient effect on the menstrual cycle has been documented. Despite concerns, cross reactivity between anti-SARS-CoV-2 spike protein antibodies and Syncytin-1, an essential protein in human implantation, is absent. There is no influence of mRNA SARS-CoV-2 vaccine on patients' performance during their immediate subsequent ART cycle. Pregnancy rates post-vaccination are similar to those in unvaccinated patients. WIDER IMPLICATIONS This review highlights existing knowledge on the impact of SARS-CoV-2 infection or COVID-19 on fertility and assisted reproduction, but also identifies gaps and offers suggestions for future research. The knowledge presented should help to provide evidence-based advice for practitioners and couples contemplating pregnancy alike, facilitating informed decision-making in an environment of significant emotional turmoil.
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Affiliation(s)
- Baris Ata
- Obstetrics and Gynecology Department, Koc University, Istanbul, Turkey.,ART Fertility Clinics, Dubai, United Arab Emirates
| | | | - Edgar Mocanu
- Department of Reproductive Medicine, Rotunda Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luca Gianaroli
- Società Italiana Studi di Medicina della Riproduzione, S.I.S.Me.R. Reproductive Medicine Institute, Bologna, Emilia-Romagna, Italy
| | - Kersti Lundin
- Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Juha S Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics and Gynaecology, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Anna Veiga
- Barcelona Stem Cell Bank, IDIBELL Programme for Regenerative Medicine, Barcelona, Spain
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Xu CS, Yang WX. ACE2 in male genitourinary and endocrine systems: Does COVID-19 really affect these systems? Histol Histopathol 2023; 38:261-272. [PMID: 36069179 DOI: 10.14670/hh-18-510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The virus that causes COVID-19 (Corona Virus Disease 2019), SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), is causing a worldwide pandemic, posing a substantial threat to human health. Patients show signs of pneumonia, ARDS, shock, acute cardiac injury, acute kidney injury and other complications. The SARS-CoV-2 receptor is angiotensin converting enzyme 2 (ACE2), which is an important component of the renin-angiotensin system (RAS). In addition, TMPRSS2 or other cofactors are needed to allow the virus to enter the host. Clinical patients have exhibited varying degrees of genitourinary and endocrine system damage, and some studies have also reported potential risks to the genitourinary and endocrine systems. This article reviews the mechanism underlying SARS-CoV-2 infection and the current studies on the male genitourinary and endocrine systems and proposes that more attention should be directed towards human reproductive and endocrine health during the SARS-CoV-2 epidemic.
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Affiliation(s)
- Chen-Shuo Xu
- The Sperm Laboratory, College of Life Sciences, Zhejiang University, Hangzhou, China
| | - Wan-Xi Yang
- The Sperm Laboratory, College of Life Sciences, Zhejiang University, Hangzhou, China.
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Rago V, Perri A. SARS-CoV-2 Infection and the Male Reproductive System: A Brief Review. Life (Basel) 2023; 13:life13020586. [PMID: 36836943 PMCID: PMC9966870 DOI: 10.3390/life13020586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Many studies have suggested that SARS-CoV-2, directly or indirectly, can affect the male reproductive system, although the underlined mechanisms have not been completely elucidated yet. The purpose of this review is to provide a summary of the current data concerning the impact of SARS-CoV-2 infection on the male urogenital tract, with a particular emphasis on the testes and male fertility. The main data regarding the morphological alterations in the testes emerged from autoptic studies that revealed interstitial congestion, micro thrombosis, reduction of Sertoli, Leydig, and germinal cells, infiltrated immune cells, and atrophic seminiferous tubules consistent with orchitis. Furthermore, men with severe infection exhibit sperm parameter alterations, together with abnormalities of the hypothalamic-pituitary-testis axis, strongly suggesting that SARS-CoV-2 could increase the risk of male infertility. However, despite the inadequate number of longitudinal studies, spermatogenesis and sex hormone imbalance seem to improve after infection resolution. The yet unresolved question is whether the virus acts in a direct or/and indirect manner, as discordant data related to its presence in the testis and semen have been reported. Regardless of the direct effect, it has been postulated that the cytokine storm and the related local and systemic inflammation could strongly contribute to the onset of testis dysfunction, leading to male infertility. Therefore, multicentric and longitudinal studies involving a large number of patients are needed to understand the real impact of SARS-CoV-2 infection on male reproduction.
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Affiliation(s)
- Vittoria Rago
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, CS, Italy
- Correspondence: ; Tel.: +39-0984-496210; Fax: +39-0984-493271
| | - Anna Perri
- Department of Experimental and Clinical Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, CZ, Italy
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Klepinowski T, Klepinowska M, Sagan L, Syrenicz A. Does SARS-CoV-2 Affect Human Semen? A Systematic Review and Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:669-677. [PMID: 36602657 PMCID: PMC9815676 DOI: 10.1007/s10508-022-02520-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 06/01/2023]
Abstract
Contradictory results have been reported regarding effects of the SARS-CoV-2 upon human semen. A timely and up-to-date systematic review with meta-analysis appears necessary. This study aimed to deliver pooled prevalence (PP) of SARS-CoV-2 in semen and pooled semen parameters as compared with the uninfected. The relevant databases were scanned by two authors for observational studies reporting analysis of semen in COVID-19 patients. The SARS-CoV-2-infected were assigned to group A (exposed arm), whereas the uninfected to group B (unexposed arm). Newcastle-Ottawa Scale was used to address the risk of bias. PRISMA guidelines were adopted. In case of homogenous studies, fixed-effects model was followed, whereas for heterogenous studies random-effects model was used. Of 990 studies, 24 were eligible involving 1589 subjects (947 in group A and 642 in group B). The "comparability" domain was biased the most. SARS-CoV-2 RNA was detected in three studies among 8 individuals producing the PP of 1.76% (95% CI 0.72-3.21). Sperm concentration was reduced significantly (WMD = -16.23 [95% CI -25.56 to -6.89], as well as total sperm in ejaculate (WMD = -34.84 [95% CI - 43.51 to -26.17]) and sperm volume (WMD = - 0.48 [95% CI - 0.59 to - 0.36] in group A as compared with controls. There was a non-significant effect upon progressive motility and leukocyte presence in semen. SARS-CoV-2 RNA in semen among the infected individuals is detected infrequently. By this token, sexual transmission through semen is of low probability and little concern for public health. However, significant decrease in sperm volume, sperm concentration, and total sperm in ejaculate has been noted. The current data, though, are limited, and more studies with longer follow-up are needed to evaluate the further impact.
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Affiliation(s)
- Tomasz Klepinowski
- Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, 71-252, Szczecin, Poland.
| | - Marta Klepinowska
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, 71-252, Szczecin, Poland
| | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
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Chen M, Li S, Liu S, Zhang Y, Cui X, Lv L, Liu B, Zheng A, Wang Q, Duo S, Gao F. Infection of SARS-CoV-2 causes severe pathological changes in mouse testis. J Genet Genomics 2023; 50:99-107. [PMID: 36494057 PMCID: PMC9724560 DOI: 10.1016/j.jgg.2022.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/23/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected more than 600 million people worldwide. Several organs including lung, intestine, and brain are infected by SARS-CoV-2. It has been reported that SARS-CoV-2 receptor angiotensin-converting enzyme-2 (ACE2) is expressed in human testis. However, whether testis is also affected by SARS-CoV-2 is still unclear. In this study, we generate a human ACE2 (hACE2) transgenic mouse model in which the expression of hACE2 gene is regulated by hACE2 promoter. Sertoli and Leydig cells from hACE2 transgenic mice can be infected by SARS-CoV-2 pseudovirus in vitro, and severe pathological changes are observed after injecting the SARS-CoV-2 pseudovirus into the seminiferous tubules. Further studies reveal that Sertoli and Leydig cells from hACE2 transgenic mice are also infected by authentic SARS-CoV-2 virus in vitro. After testis interstitium injection, authentic SARS-CoV-2 viruses are first disseminated to the interstitial cells, and then detected inside the seminiferous tubules which in turn cause germ cell loss and disruption of seminiferous tubules. Our study demonstrates that testis is most likely a target of SARS-CoV-2 virus. Attention should be paid to the reproductive function in SARS-CoV-2 patients.
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Affiliation(s)
- Min Chen
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100101, China
| | - Shihua Li
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Shujun Liu
- Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Yuhang Zhang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Xiuhong Cui
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Limin Lv
- Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Bowen Liu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100101, China
| | - Aihua Zheng
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100101, China.
| | - Qihui Wang
- CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Shuguang Duo
- Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Fei Gao
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100101, China.
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Pallotti F, Esteves SC, Faja F, Buonacquisto A, Conflitti AC, Hirsch MN, Lenzi A, Paoli D, Lombardo F. COVID-19 and its treatments: lights and shadows on testicular function. Endocrine 2023; 79:243-251. [PMID: 36260234 PMCID: PMC9579574 DOI: 10.1007/s12020-022-03221-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/02/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE The SARS-CoV-2 pandemic has rapidly spread worldwide and, among the others, the male gender was quickly recognized as an independent risk factor for both the disease and its consequences. Since the possibility of long-term hormonal axis changes and male gamete impairment have been hypothesized but a relatively low levels of evidence has been reached, we focused this narrative mini-review on summarizing key state-of-the-art knowledge on male reproductive effects of COVID-19 as a quick reference for reproductive health specialists. METHODS A comprehensive Medline/PubMed and Embase search was performed selecting all relevant, peer-reviewed papers in English published from 2020. Other relevant papers were selected from the reference lists. RESULTS Available evidence indicates that the likelihood of direct testicular damage from SARS-CoV-2 is somewhat low, but there are many indirect ways (fever, cytokine imbalance, and drugs) through which the pituitary-gonadal axis and spermatogenesis may be disrupted. These alterations are probably transient, but as available evidence is low quality, it cannot be excluded that previous pathologies or comorbidities might modulate the risk of their persistence. On the other hand, available evidence shows high safety regarding andrological health for available vaccines, although studies are mainly focused on mRNA vaccines. CONCLUSION A careful andrological evaluation of men recovering from COVID-19 is highly recommended. Since available evidence is relatively scarce, a careful andrological follow-up and counseling of these patients are mandatory.
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Affiliation(s)
- Francesco Pallotti
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Sandro C Esteves
- Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1464, Campinas, Brazil
- Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Fabiana Faja
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Alessandra Buonacquisto
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Anna Chiara Conflitti
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Maria Neve Hirsch
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Andrea Lenzi
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Donatella Paoli
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Francesco Lombardo
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy.
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Viruses and Endocrine Diseases. Microorganisms 2023; 11:microorganisms11020361. [PMID: 36838326 PMCID: PMC9967810 DOI: 10.3390/microorganisms11020361] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Viral infections have been frequently associated with physiological and pathological changes in the endocrine system for many years. The numerous early and late endocrine complications reported during the current pandemic of coronavirus disease 2019 (COVID-19) reinforce the relevance of improving our understanding of the impact of viral infections on the endocrine system. Several viruses have been shown to infect endocrine cells and induce endocrine system disturbances through the direct damage of these cells or through indirect mechanisms, especially the activation of the host antiviral immune response, which may lead to the development of local or systemic inflammation or organ-specific autoimmunity. In addition, endocrine disorders may also affect susceptibility to viral infections since endocrine hormones have immunoregulatory functions. This review provides a brief overview of the impact of viral infections on the human endocrine system in order to provide new avenues for the control of endocrine diseases.
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Stigliani S, Massarotti C, Bovis F, Maccarini E, Anserini P, Scaruffi P. Semen parameters and male reproductive potential are not adversely affected after three or more months of recovery from COVID-19 disease. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 4:1114308. [PMID: 36743823 PMCID: PMC9895115 DOI: 10.3389/frph.2022.1114308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/30/2022] [Indexed: 01/22/2023] Open
Abstract
Background The male reproductive system may be a potential target for SARS-CoV-2 since the presence of ACE and TMPRS2 receptors. After a first report of the presence of SARS-CoV-2 in semen of COVID-19 patients, several papers reported that SARS-CoV-2 was not detected in the semen. However, some evidences indicated that COVID-19 disease could impair semen parameters. During the infection, or in a short period after, a reduction in sperm concentration and motility and an increase in DNA fragmentation were observed, even in asymptomatic patients. There is no conclusive data exploring whether this damage changes with time. We investigated whether COVID-19 disease has a negative impact on semen parameters and male reproductive potential after recovery. Methods In this longitudinal retrospective study, we enrolled 20 men who had COVID-19 disease. We compared sperm parameters in samples collected before COVID-19 and after infection (8.3 ± 4.8 months). We also evaluated the reproductive potential in pre- and post-COVID-19 infertility treatments of 8 self-controlled couples as well as in 40 cycles after COVID-19 infection of the male partner. Results For most patients, we obtained results of more than one semen analysis before and after COVID-19. After adjusting for age, days of sexual abstinence, frequency of ejaculations and presence of fever, we found no significant difference over time in any semen parameter. The interval between COVID-19 infection and subsequent infertility treatments was 10.7 ± 7.5 months. There were no differences in the embryological and clinical outcomes of infertility treatments performed before and after male infection. One couple obtained a single pregnancy in the post COVID-19 IUI. Normal fertilization (65%), cleavage (99%) and blastocyst development (40%) rates in treatments performed after male infection were within the expected range of competencies. A total of 5 singleton and 1 twin clinical pregnancies were obtained, and 6 healthy children were born. A total of 10 blastocysts have been cryopreserved. Conclusion Our data are reassuring that COVID-19 disease has no negative effect on semen quality and male reproductive potential when semen samples are collected three months or more after infection.
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Affiliation(s)
- Sara Stigliani
- UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Claudia Massarotti
- UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genova, Italy,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Health (DiNOGMI), University of Genova, Genova, Italy
| | - Francesca Bovis
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Elena Maccarini
- UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Paola Anserini
- UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Paola Scaruffi
- UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genova, Italy,Correspondence: Paola Scaruffi
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Mohammed N, Kamel M, Gadelkareem RA, Zarzour MA, Kurkar A, Abdel-Moniem AM, Behnsawy H. Semen quality changes during infection and recovery phases of mild-to-moderate COVID-19 in reproductive-aged patients: a prospective case series. Basic Clin Androl 2023; 33:2. [PMID: 36653786 PMCID: PMC9848703 DOI: 10.1186/s12610-022-00175-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/01/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Despite the documented effects of the coronavirus disease 2019 (COVID-19) on spermatogenesis, the reversibility of these effects is uncertain. We aimed to assess the changes of sperm quality between the infection and recovery phases of COVID-19 in reproductive-aged men. The semen quality of men with mild-to-moderated COVID-19 (defined by the degrees of symptoms and chest involvement on computed tomography) was studied during October, 2020-May, 2021 at our hospital. Two semen samples were analyzed at timings estimated to represent spermatogenic cycles during the infection and recovery phases of COVID-19. RESULTS A total of 100 patients were included with mean ± SD (range) age of 24.6 ± 3.3 (21-35) years. During infection, 33% of patients had abnormal semen quality. However, a significant reduction was found in this abnormality from 33 to 11% (P < 0.001) after recovery from infection. In a comparison of the two semen analyses, there were significant improvements in the mean values of sperm progressive motility (P =0.043) and normal morphology (P < 0.001). However, the mean sperm concentration showed a statistically insignificant increase (P = 0.844). CONCLUSIONS In reproductive-aged patients with mild-to-moderate COVID-19, the effects on seminal quality were recoverable, represented by significant improvements in the means of progressive sperm motility and normal morphology between the infection and recovery phases of COVID-19. TRIAL REGISTRATION ClinicalTrials, NCT04595240 .
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Affiliation(s)
- Nasreldin Mohammed
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt
| | - Mostafa Kamel
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt
| | - Rabea Ahmed Gadelkareem
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt.
| | - Mohammed Ali Zarzour
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt
| | - Adel Kurkar
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt
| | - Ahmed Mohammed Abdel-Moniem
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt
| | - Hosny Behnsawy
- Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut, Egypt
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