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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Cao M, Han Y, Feng T, Lu P, Wang Y, Sun Q, Zhao Z, Pan W. Impact of COVID-19 convalescence on pregnancy outcomes in patients undergoing IVF/ICSI during fresh ART cycles: a retrospective cohort study. Front Endocrinol (Lausanne) 2024; 14:1298995. [PMID: 38348053 PMCID: PMC10860335 DOI: 10.3389/fendo.2023.1298995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/20/2023] [Indexed: 02/15/2024] Open
Abstract
Objective The aim was to study the impact of coronavirus disease 2019 (COVID-19) convalescence on female fertility and laboratory and clinical outcomes in fresh assisted reproductive technology (ART) cycles. Methods In this retrospective cohort study, we analyzed data from 294 patients who had recovered from COVID-19 and who underwent fresh ART cycles between January and March 2023 (COVID-19 group). This group was compared with 631 patients who underwent similar ART cycles in the same period in 2022 but without having been infected with COVID-19 (non-COVID-19 group). The analysis focused on comparison of basic demographic characteristics and laboratory parameters of patients in each group. The primary outcome measure was the clinical pregnancy rate, which was examined to assess the impact of COVID-19 infection on the efficacy of ART treatment. Results Basal follicle-stimulating hormone (FSH) levels were significantly lower and antral follicle count (AFC) was markedly higher in the COVID-19 group compared to the non-COVID-19 group (P<0.001 and P=0.004, respectively). The predominant ovarian stimulation protocol in the COVID-19 group was GnRH antagonists (64.85%, P<0.001), with a reduced gonadotropin (Gn) dosage and duration in comparison to the non-COVID-19 group (P<0.05). Although the number of blastocysts formed was lower in the COVID-19 group (P=0.017), this group also exhibited a higher blastocyst freezing rate and a higher rate of high-quality embryos per retrieved oocyte (P<0.001 and P=0.023, respectively). Binary logistic regression analysis indicated that COVID-19 convalescence did not significantly impact clinical pregnancy rates in fresh transfer cycles (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.68-1.96, P=0.5874). However, smooth curve-fitting and threshold effect analysis revealed an age-related decline in clinical pregnancy rates in both groups, more pronounced in the COVID-19 group, for women aged over 38 years, with the likelihood of clinical pregnancy decreasing by 53% with each additional year of age (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.61-1.08, P=0.1460; odds ratio [OR] = 0.47, 95% CI = 0.21-1.05, P=0.0647). Conclusions Our findings present no substantial evidence of adverse effects on clinical pregnancy outcomes in fresh ART cycles in patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) during the period of convalescence from COVID-19. However, age emerges as a significant factor influencing these outcomes. Notably, for women above 38 years of age, the likelihood of clinical pregnancy in patients with a prior COVID-19 infection decreased by 53% with each additional year. This highlights the importance of considering maternal age, especially in the context of COVID-19, when evaluating the likelihood of successful pregnancy following ART treatments.
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Affiliation(s)
- Mingya Cao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yan Han
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tengfei Feng
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Peiyang Lu
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yue Wang
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qingyun Sun
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhiming Zhao
- Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wensen Pan
- Second Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Amodeo A, Persani L, Bonomi M, Cangiano B. Use of testosterone replacement therapy to treat long-COVID-related hypogonadism. Endocrinol Diabetes Metab Case Rep 2024; 2024:23-0097. [PMID: 38520748 PMCID: PMC10959025 DOI: 10.1530/edm-23-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/07/2024] [Indexed: 03/25/2024] Open
Abstract
Summary Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can impair pituitary-gonadal axis and a higher prevalence of hypogonadism in post-coronavirus disease 2019 (COVID-19) patients compared with the general population has been highlighted. Here we report the first case of a patient affected with a long-COVID syndrome leading to hypogonadism and treated with testosterone replacement therapy (TRT) and its effects on clinical and quality of life (QoL) outcomes. We encountered a 62-year-old man who had been diagnosed with hypogonadotropic hypogonadism about 2 months after recovery from COVID-19 underwent a complete physical examination, general and hormonal blood tests, and self-reported questionnaires administration before and after starting TRT. Following the TRT, both serum testosterone level and hypogonadism-related symptoms were improved, but poor effects occurred on general and neuropsychiatric symptoms and QoL. Therefore, hypogonadism does not appear to be the cause of neurocognitive symptoms, but rather a part of the long-COVID syndrome; as a consequence, starting TRT can improve the hypogonadism-related symptoms without clear benefits on general clinical condition and QoL, which are probably related to the long-COVID itself. Longer follow-up might clarify whether post-COVID hypogonadism is a transient condition that can revert as the patient recovers from long-COVID syndrome. Learning points Hypogonadism is more prevalent in post-COVID-19 patients compared with the general population. In these patients, hypogonadism may be part of long-COVID syndrome, and it is still unclear whether it is a transient condition or a permanent impairment of gonadal function. Testosterone replacement therapy has positive effects on hypogonadism-related clinic without clear benefits on general symptomatology and quality of life, which are more likely related to the long-COVID itself.
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Affiliation(s)
- Alessandro Amodeo
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Luca Persani
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marco Bonomi
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Biagio Cangiano
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Groti Antonic K, Antonic B, Caliber M, Dhindsa S. Men, testosterone and Covid-19. Clin Endocrinol (Oxf) 2024; 100:56-65. [PMID: 37501254 DOI: 10.1111/cen.14952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Men have more severe Coronavirus disease 2019 (Covid-19) outcomes and higher mortality rates than women, and it was suggested that testosterone levels might promote severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and Covid-19 severity. However, clinical studies have not supported this theory. Studies have consistently shown that serum testosterone concentrations during acute Covid-19 in men are inversely proportional to the inflammatory cytokines and severity of illness. It is likely that lower testosterone concentrations in this setting are a result of acute Covid-19 illness on the hypothalamic-pituitary-testicular axis. Clinical trials that attempted to lower testosterone concentrations further or block androgen signaling acutely during Covid-19 in men did not result in improved Covid-19 outcomes. Additionally, pre-existing male hypogonadism, diagnosed before Covid-19 pandemic, was found to be a risk factor for hospitalization from Covid-19. In this review, we also discuss the preclinical and mechanistic studies that have evaluated the role of androgens in SARS-CoV-2 infection and illness. Finally, long-term consequences of Covid-19 on male reproductive health are reviewed. SARS-CoV-2 virus is known to infiltrate testis and induce orchitis in men, but it is unclear if Covid-19 leads to an increase in incidence of male hypogonadism.
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Affiliation(s)
- Kristina Groti Antonic
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Monica Caliber
- American Medical Writers Association, Miami, Florida, USA
| | - Sandeep Dhindsa
- Division of Endocrinology and Metabolism, Saint Louis University, Saint Louis, Missouri, USA
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Li G, Zhang R, Song B, Wang C, Shen Q, He X, Cao Y. Effects of SARS-CoV-2 Vaccines on Sperm Quality: Systematic Review. JMIR Public Health Surveill 2023; 9:e48511. [PMID: 37976132 DOI: 10.2196/48511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/06/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by SARS-CoV-2, has triggered a global public health crisis of unprecedented proportions. SARS-CoV-2 vaccination is a highly effective strategy for preventing infections and severe COVID-19 outcomes. Although several studies have concluded that COVID-19 vaccines are unlikely to affect fertility, concerns have arisen regarding adverse events, including the potential impact on fertility; these concerns are plagued by limited and inconsistent evidence. OBJECTIVE This review aims to provide a recent assessment of the literature on the impact of COVID-19 vaccines on male sperm quality. The possible impact of COVID-19 vaccines on fertility potential was also examined to draw a clearer picture and to evaluate the effects of COVID-19 on male reproductive health. METHODS PubMed, Scopus, Web of Science, Embase, and Cochrane databases were searched from their inception to October 2023. Eligible studies included articles reporting SARS-CoV-2 vaccination and human semen quality and fertility, as well as the impact of vaccination on assisted reproductive technology treatment outcomes. The quality of cohort studies was assessed using the Newcastle-Ottawa Scale, and the quality of cross-sectional studies was assessed using the quality evaluation criteria recommended by the Agency for Healthcare Research and Quality. The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS The initial literature search yielded 4691 records by searching 5 peer-reviewed databases (PubMed, Scopus, Web of Science, Embase, and Cochrane). Finally, 24 relevant studies were selected for our study. There were evident research inequalities at the regional level, with the United States and Western European countries contributing 38% (9/24) of the studies, Middle Eastern countries contributing 38% (9/24), China accounting for 21% (5/24), and Africa and South America accounting for none. Nonetheless, the overall quality of the included studies was generally good. Our results demonstrated that serious side effects of the COVID-19 vaccine are extremely rare, and men experience few problems with sperm parameters or reproductive potential after vaccination. CONCLUSIONS On the basis of the studies published so far, the COVID-19 vaccine is safe for male reproductive health. Obviously, vaccination is a wise option rather than experience serious adverse symptoms of viral infections. These instances of evidence may help reduce vaccine hesitancy and increase vaccination coverage, particularly among reproductive-age couples. As new controlled trials and prospective cohort studies with larger sample sizes emerge, the possibility of a negative effect of the COVID-19 vaccine on sperm quality must be further clarified.
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Affiliation(s)
- Guanjian Li
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Rongqiu Zhang
- Reproductive Medicine Center, the Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China
- The Second People's Hospital of Guiyang, Guiyang, China
| | - Bing Song
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Chao Wang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Qunshan Shen
- Reproductive Medicine Center, Human Sperm Bank, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, China
| | - Xiaojin He
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunxia Cao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- National Health Commission Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
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Aversa A, Iuliano S. Male sexual and reproductive health after COVID-19 pandemic: where are we now? Panminerva Med 2023; 65:441-442. [PMID: 36951149 DOI: 10.23736/s0031-0808.23.04851-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, Magna Grecia University, Catanzaro, Italy -
| | - Stefano Iuliano
- Department of Experimental and Clinical Medicine, Magna Grecia University, Catanzaro, Italy
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Edele Santos D, Colonetti T, Rodrigues Uggioni ML, Rech P, Marcelino Baptista M, Medeiros LR, Grande AJ, Rosa MI. Effects of COVID-19 or vaccines for SARS-COV-2 on sperm parameters: A systematic review and meta-analysis. J Reprod Immunol 2023; 160:104140. [PMID: 37696225 DOI: 10.1016/j.jri.2023.104140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/17/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
This systematic review and meta-analysis assessed the effects of SARS-Cov-2 and mRNA vaccines on male reproduction. We conducted a comprehensive search using terms such as "COVID-19," "vaccine," and "sperm parameters" on various electronic databases, including MEDLINE (PubMed), BVS (LILACS and others), Embase (Elsevier), and Cochrane Library. We included observational studies, including cohort, case-control, and cross-sectional studies. Of the 2054 records initially identified, we carefully examined 47 full-text articles and excluded 26 articles for specific reasons, ultimately including 21 studies for our analysis. Among these, 16 studies focused on assessing seminal parameters in patients with COVID-19, while five studies investigated the effects of COVID vaccines on seminal parameters. A meta-analysis of seminal parameters in men before and after the COVID-19 pandemic revealed significant differences in seminal concentration, progressive motility, total motility, and normal morphology. These findings indicate a positive impact of the analyzed parameters before the onset of COVID-19. However, the quality of the evidence was considered low. In contrast, a meta-analysis of five studies evaluating seminal parameters before and after the SARS-Cov-2 vaccine did not show any significant differences in total motility. This analysis, involving 256 men from four studies, provided low-quality evidence, suggesting that mRNA vaccines do not affect male reproduction. Overall, our findings suggest that seminal parameters exhibit considerable variability depending on specific outcomes and the study design. However, based on available evidence, it appears that mRNA vaccines do not have detrimental effects on male reproductive function.
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Affiliation(s)
- Diogo Edele Santos
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil
| | - Tamy Colonetti
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil
| | - Maria Laura Rodrigues Uggioni
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil
| | - Peterson Rech
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil
| | - Mateus Marcelino Baptista
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil
| | - Lidia Rosi Medeiros
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil
| | - Antonio José Grande
- Laboratory of Evidence-based Practice, Universidade Estadual de Mato Grosso do Sul, Av. Dom Antonio Barbosa (MS-080), 4.155, CEP 79115-898 Campo Grande, MS, Brazil; Graduate Program in Infectious and Parasitic Diseases, School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Maria Inês Rosa
- Laboratory of Translational Biomedicine, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Universitário, CEP 88806-000 Criciúma, SC, Brazil.
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Corona DG, Vena W, Pizzocaro A, Rastrelli G, Sparano C, Sforza A, Vignozzi L, Maggi M. Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study. J Endocrinol Invest 2023; 46:2195-2211. [PMID: 37515706 DOI: 10.1007/s40618-023-02136-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/09/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED. METHODS All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively. RESULTS Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal. CONCLUSIONS The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.
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Affiliation(s)
- D G Corona
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy.
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - C Sparano
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - A Sforza
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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11
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Panner Selvam MK, Kapoor A, Baskaran S, Moharana AK, Sikka SC. A Scientometric Evaluation of COVID-19 and Male Reproductive Research. Clin Pract 2023; 13:1319-1330. [PMID: 37987419 PMCID: PMC10660474 DOI: 10.3390/clinpract13060118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
The COVID-19 pandemic due to the SARS-CoV-2 coronavirus showed acute and prolonged effects on human health. In addition, over the past four years, there has been a tremendous surge in COVID-19-related scientific publications, as shown by bibliometric and scientometric studies. However, such analysis of the scientific literature is lacking in the area of male reproduction. The current scientometric study analyzes publication characteristics of articles related to male reproduction and COVID-19 infection. We used the Scopus database to analyze scientometric data (the number of publications, journals, countries, type of documents, and subject area) related to COVID-19 and male reproductive research. Our literature search identified 345 articles related to COVID-19 and male reproductive research. Most of the articles were published in the USA (n = 72), Italy (n = 55), and China (n = 51). Such research was mainly focused around medicine (57.1%), followed by biochemistry, genetics, and molecular biology (25.7%). Also, in the area of male reproduction, only 37.1% (n = 128) of the articles contributed towards original research, whereas 52.8% (n = 182) were review articles and editorials focusing more on sexual dysfunction than infertility. Such a small number of studies published on COVID-19-related effects on male reproduction warrants a significant increase in research, which is required to decipher the mechanism(s) underlying SARS-CoV-2 infection-associated impairment of male reproductive function.
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Affiliation(s)
- Manesh Kumar Panner Selvam
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
| | | | - Saradha Baskaran
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
| | - Ajaya Kumar Moharana
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
- Redox Biology & Proteomics Laboratory, Department of Zoology, School of Life Sciences, Ravenshaw University, Cuttack 753003, Odisha, India
| | - Suresh C. Sikka
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA 70112, USA; (S.B.); (A.K.M.)
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13
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Wei L, Zhang J, Deng X, Luo C, Bo L, Gao S, Qian F, Lu S, Mao C. Impacts of the COVID-19 pandemic on Chinese assisted reproductive technology institutions and human sperm banks: reflections in the post-pandemic era. J Health Popul Nutr 2023; 42:82. [PMID: 37592335 PMCID: PMC10436387 DOI: 10.1186/s41043-023-00422-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 07/21/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has been the most serious public health emergency encountered in modern assisted reproductive technology (ART) development. In order to identify lessons learned, this study reviews the effect of the pandemic on ART institutions and human sperm banks in China, and summarizes the experiences and reflections of Chinese scholars post-pandemic era. METHODS This review is based on multiple consensus statements on the COVID-19 pandemic issued by Chinese experts as well as current national regulations and principles in ART institutions and human sperm banks to document the current situation of ART services in China, describe the impact of the pandemic on these services, and offer Chinese reflections on worrying issues in the post-pandemic era. RESULTS China reached one million ART cycles in 2016, and there are currently 540 ART medical institutions and 27 human sperm banks, with 540 licensed for AIH, 91 for AID, 415 for conventional IVF and ICSI and 85 for PGT. Of these, only 4 institutions carry out 10,000 cycles or more annually, and the proportion of institutions with less than 1,000 cycles has reached 66%, which means that a considerable number of ART institutions are still not saturated. As a consequence of the COVID-19 pandemic, 63.6% of ART providers and 95.5% of human sperm banks suspended operations. By the end of May 2020, China, as an early country affected by the pandemic achieved a national resumption rate of ART medical services of 99.2% and that of human sperm banks of 100.0%. Reports from the first and largest human sperm bank in China showed that qualification, semen concentration and sperm viability rates measured at primary screening have significantly decreased post-pandemic. Much like in other countries, Chinese experts developed a consensus on prevention and control measures during the pandemic. In principle, all ART activities should be suspended during acute phases of infection spread. Chinese scholars highlight that attention should be paid to young patients with fertility requirements during and after COVID-19, and emphasize the importance of fertility evaluation and clinical intervention. In addition, couples should be reminded that during ART treatment, disinfectants should not be used excessively to minimize risks of damaging the reproductive system, gametes and zygotes. At the same time, timely and reasonable guidance for tackling negative emotions from stress response is needed to provide reassurance and to avoid irrational fear and excessive stress. Seminal parameters should be re-examined 2 months after SARS-CoV-2 vaccination, and ART treatments recommenced if no abnormalities are detected. CONCLUSIONS Given the growing frequency of outbreaks of global infectious diseases in recent years, ART institutions and human sperm banks should pay attention to improving their prevention and control capabilities. To a certain extent, decisions and measures adopted in China during COVID-19 pandemic are worthy of recognition and acceptance. Chinese scholars have discussed, proactively responded to and understand the key issues surrounding ART development during the pandemic with the aim of contributing to the substantial progress and healthy development of ART services in the world.
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Affiliation(s)
- Lun Wei
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Jiakai Zhang
- Centre for Chinese Urbanization Studies & Collaborative Innovation Center for New Urbanization and Social Governance of Universities in Jiangsu, Soochow University, No.50 Donghuan Road, Suzhou, 215021, Jiangsu, China
- Suzhou High School Affiliated to Xi'an Jiaotong University, Suzhou, Jiangsu, China
| | - Xiaoling Deng
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Chao Luo
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Le Bo
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Shasha Gao
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Fei Qian
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China
| | - Shucheng Lu
- Centre for Chinese Urbanization Studies & Collaborative Innovation Center for New Urbanization and Social Governance of Universities in Jiangsu, Soochow University, No.50 Donghuan Road, Suzhou, 215021, Jiangsu, China.
| | - Caiping Mao
- Reproductive Medicine Center, First Affiliated Hospital of Soochow University, No.899 Pinghai Road, Suzhou, 215006, Jiangsu, China.
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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15
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Guiton R, Drevet JR. Viruses, bacteria and parasites: infection of the male genital tract and fertility. Basic Clin Androl 2023; 33:19. [PMID: 37468865 DOI: 10.1186/s12610-023-00193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/05/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Infertility affects one couple out of six worldwide. Male infertilty can result from congenital or acquired factors, of which pathogens that reach the genital tract through sexual contact or blood dissemination. The impact of major viral, bacterial and parasitic infections on the male genital tract and fertility has been summarized. RESULTS AND CONCLUSIONS A systematic review of articles published in the Google Scholar and PubMed databases was conducted. It turns out that viruses, as well as bacteria and parasites are major inducers of male genital tract infections and ensuing infertility through damage to the organs and subsequent loss of function and/or through direct damage to the sperm cells. Moreover, not only male infertility results from such infections but these can also be transmitted to women and even to the offspring, thus highlighting the need to efficiently detect, treat and prevent them.
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Affiliation(s)
- Rachel Guiton
- Université Clermont Auvergne, CNRS UMR6293, GReD Institute, 63001, Clermont-Ferrand, France.
| | - Joël R Drevet
- Université Clermont Auvergne, CNRS UMR6293, GReD Institute, 63001, Clermont-Ferrand, France
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16
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Martinez MS, Ferreyra FN, Paira DA, Rivero VE, Olmedo JJ, Tissera AD, Molina RI, Motrich RD. COVID-19 associates with semen inflammation and sperm quality impairment that reverses in the short term after disease recovery. Front Physiol 2023; 14:1220048. [PMID: 37497433 PMCID: PMC10366368 DOI: 10.3389/fphys.2023.1220048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction: COVID-19 exerts deleterious effects on the respiratory, cardiovascular, gastrointestinal, and central nervous systems, causing more severe disease in men than in women. However, cumulative reported data about the putative consequences on the male reproductive tract and fertility are controversial. Furthermore, the long-term effects of SARS-CoV-2 infection are still uncertain. Methods: In this study, we prospectively evaluated levels of inflammatory cytokines and leukocytes in semen and sperm quality parameters in a cohort of 231 reproductive-aged male patients, unvaccinated, who had recovered from mild or severe COVID-19 and in 62 healthy control individuals. Sperm quality was assessed early (less than 3 months) and long (more than 3 and up to 6 months) after having COVID-19. Interestingly, and unlike most reported studies, available extensive background and baseline data on patients' sperm quality allowed performing a more accurate analysis of COVID-19 effects on sperm quality. Results: Significantly higher levels of IL-1β, TNF and IFNγ were detected in semen from patients recently recovered from mild and/or severe COVID-19 with respect to control individuals indicating semen inflammation. Moreover, patients recovered from mild and/or severe COVID-19 showed significantly reduced semen volume, lower total sperm counts, and impaired sperm motility and viability. Interestingly, all observed alterations returned to baseline values after 3 or more months after disease recovery. Discussion: These results indicate that COVID-19 associates with semen inflammation and impaired semen quality early after disease. However, long COVID-19 seems not to include long-term detrimental consequences on male fertility potential since the observed alterations were reversible after 1-2 spermatogenesis cycles. These data constitute compelling evidence allowing a better understanding of COVID-19 associated sequelae, fundamental for semen collection in assisted reproduction.
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Affiliation(s)
- María Sol Martinez
- CIBICI-CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Daniela Andrea Paira
- CIBICI-CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Virginia Elena Rivero
- CIBICI-CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - José Javier Olmedo
- Fundación Urológica Córdoba para la Docencia e Investigación Médica (FUCDIM), Córdoba, Argentina
| | - Andrea Daniela Tissera
- Fundación Urológica Córdoba para la Docencia e Investigación Médica (FUCDIM), Córdoba, Argentina
| | - Rosa Isabel Molina
- Fundación Urológica Córdoba para la Docencia e Investigación Médica (FUCDIM), Córdoba, Argentina
| | - Rubén Darío Motrich
- CIBICI-CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
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17
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Edimiris P, Doehmen C, Müller L, Andrée M, Baston-Buest DM, Buest S, Adams O, Krüssel JS, Bielfeld AP. Mild COVID-19 has no detrimental effect on semen quality. Basic Clin Androl 2023; 33:15. [PMID: 37316770 DOI: 10.1186/s12610-023-00190-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/06/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND As of today, the effect of coronavirus disease 2019 (COVID-19) on male fertility remains unclear. Studies published so far have partly contradictory results, likely due to very small sample sizes and heterogeneous populations. To gain a deeper understanding of the impact of COVID-19 on male fertility, we performed a prospective case-control study, in which we examined the ejaculate of 37 subjects, including 25 subjects in the acute phase of mild COVID-19 and 12 subjects who did not suffer from COVID-19. Determination of semen parameters, severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) qPCR, and infectivity analysis were performed in the acute phase of the disease and in series. RESULTS Semen parameter values did not differ significantly between subjects with mild COVID-19 and the control group. The serial examination of semen parameters revealed no significant changes between 4, 18, and 82 days after the onset of symptoms. SARS-CoV-2 RNA or infectious particles could not be detected in any ejaculate. CONCLUSION Mild COVID-19 seems to have no detrimental effect on semen parameter values.
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Affiliation(s)
- Philippos Edimiris
- Department of OB/GYN and REI (UniKiD), Medical Center, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
| | - Cornelius Doehmen
- Department of OB/GYN and REI (UniKiD), Medical Center, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
- Kinderwunschzentrum Niederrhein, Madrider Str. 6, 41069, Moenchengladbach, Germany
| | - Lisa Müller
- Institute of Virology, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Marcel Andrée
- Institute of Virology, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Dunja Maria Baston-Buest
- Department of OB/GYN and REI (UniKiD), Medical Center, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Sebastian Buest
- Department of OB/GYN and REI (UniKiD), Medical Center, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Ortwin Adams
- Institute of Virology, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Jan-Steffen Krüssel
- Department of OB/GYN and REI (UniKiD), Medical Center, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Alexandra Petra Bielfeld
- Department of OB/GYN and REI (UniKiD), Medical Center, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
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18
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Birtolo MF, Vena W, Pizzocaro A, Lavezzi E, Brunetti A, Jaafar S, Betella N, Bossi AC, Mazziotti G, Lania AG. Serum testosterone mirrors inflammation parameters in females hospitalized with COVID-19. J Endocrinol Invest 2023; 46:939-945. [PMID: 36370325 PMCID: PMC9660177 DOI: 10.1007/s40618-022-01957-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND While low testosterone (T) was described as a predictor of unfavorable coronavirus-disease 19 (COVID-19) outcome in men, data concerning the role of T in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are scant and limited to small cohorts. This study investigated the relationship between serum T values and outcomes of COVID-19 in a large female hospitalized cohort. METHODS One-hundred-sixty-eight adult women (median age 77, range 18-100 years; 154 in post-menopause) hospitalized for COVID-19 were assessed for PaO2/Fio2 ratio, serum T and inflammatory parameters. RESULTS Median duration for hospital stay was 14.2 days (range 1-115) with overall mortality of 26% (n = 44). Subjects who died were significantly older (p < 0.001), had significantly more comorbidities (p = 0.015) and higher serum T (p = 0.040), white blood cells (p = 0.007), c-reactive protein (CRP; p < 0.001), interleukin-6 (IL-6; p < 0.001), procalcitonin (PCT; p < 0.001), lactate dehydrogenase (LDH; p = 0.001), D-dimer (p = 0.035), fibrinogen (p = 0.038) and lower serum free-triiodothyronine (FT3; p < 0.001) and luteinizing hormone (LH; p = 0.024) values. In post-menopausal women, significant associations were observed between T levels and serum CRP (rho: 0.23; p = 0.002), IL-6 (rho: 0.41; p < 0.001), LDH (rho: 0.34; p < 0.001), D-Dimer (rho: 0.21; p = 0.008), PCT (rho: 0.26; p = 0.001) and HDL cholesterol (rho: - 0,22, p = 0.008). In multivariate regression analyses, serum T maintained the significant association with mortality after correction for age, coexistent comorbidities and serum LH and FT3, whereas it was lost after correction for inflammatory parameters. CONCLUSION In females, high serum T levels might be a mirror of inflammatory phenotype and worse COVID-19 course.
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Affiliation(s)
- M F Birtolo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - W Vena
- Diabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy.
| | - A Pizzocaro
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - E Lavezzi
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - A Brunetti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - S Jaafar
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - N Betella
- Diabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy
| | - A C Bossi
- Diabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy
| | - G Mazziotti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - A G Lania
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
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Al-Kuraishy HM, Al-Gareeb AI, Alarfaj SJ, Al-Akeel RK, Faidah H, El-Bouseary MM, Sabatier JM, De Waard M, El-Masry TA, Batiha GES. Long COVID and risk of erectile dysfunction in recovered patients from mild to moderate COVID-19. Sci Rep 2023; 13:5977. [PMID: 37045862 PMCID: PMC10092929 DOI: 10.1038/s41598-023-32211-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
Patients with coronavirus disease 2019 (COVID-19) were shown to have reduced serum testosterone levels compared to healthy individuals. Low testosterone levels are linked with the development of erectile dysfunction (ED). In this case-controlled study, 20 healthy controls and 39 patients with ED 3 months after recovering from mild-to-moderate COVID-19 pneumonia were studied. The patients ranged in age from 31 to 47 years. To identify early and late COVID-19 infections, real-time polymerase-chain reaction (RT-PCR) and COVID-19 antibody testing were done. The levels of luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), free testosterone (FT), free androgenic index (FAI), and sex hormone-binding globulin (SHBG) were measured. The sexual health inventory for patients (SHIM) score was used to measure the erectile function of the patients and controls. When compared to the controls, the TT serum level in long COVID-19 (LC) patients with ED was low (p = 0.01). In contrast to controls, FT and FAI were both lower in LC patients with ED. (p = 0.001). FSH serum levels did not significantly differ (p = 0.07), but in ED patients, LH serum levels were elevated. SHIM scores were associated with low TT (p = 0.30), FT (p = 0.09), and high LH (p = 0.76) in LC patients with ED. Male patients with decreased serum levels of LH and testosterone may have hypothalamic-pituitary-gonadal axis dysfunction, which could lead to the development of LC-induced ED. Therefore, an in-depth research is necessary to confirm the causal link between COVID-19 and ED in LC patients.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq
| | - Sumaiah J Alarfaj
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, P.O.Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Rasha Khalifah Al-Akeel
- Department of Zoology, Faculty of Entomology and Parasitology, King Saud University, Riyadh, Saudi Arabia
| | - Hani Faidah
- Microbiolgy Department Faculty of Medicine, Umm Al Qura University, Mecca, Saudi Arabia
| | - Maisra M El-Bouseary
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Jean-Marc Sabatier
- CNRS UMR 7051, Faculté des Sciences Médicales et Paramédicales, Institut de Neurophysiopathologie (INP), Aix-Marseille Université, 27 Bd Jean Moulin, 13005, Marseille, France
| | - Michel De Waard
- Smartox Biotechnology, 6 Rue Des Platanes, 38120, Saint-Egrève, France
- L'institut du Thorax, INSERM, CNRS, UNIV NANTES, 44007, Nantes, France
- LabEx «Ion Channels, Science & Therapeutics», Université de Nice Sophia-Antipolis, 06560, Valbonne, France
| | - Thanaa A El-Masry
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt
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20
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Zhang W, Wang L, Sun J, Cui L, Zhang H, Hu J. The impact of the COVID-19 pandemic on semen quality of uninfected men. Basic Clin Androl 2023; 33:4. [PMID: 36890443 PMCID: PMC9995173 DOI: 10.1186/s12610-022-00180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/29/2022] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since its discovery in December 2019. Research published since the COVID-19 outbreak has focused on whether semen quality and reproductive hormone levels are affected by COVID-19. However, there is limited evidence on semen quality of uninfected men. This study aimed to compare semen parameters among uninfected Chinese sperm donors before and after the COVID-19 pandemic to determine the impact of the COVID-19 pandemic-related stress and lifestyle changes on uninfected men. RESULTS All semen parameters were non-significant except semen volume. The average age of sperm donors was higher after the COVID-19 (all P < 0.05). The average age of qualified sperm donors increased from 25.9 (SD: 5.3) to 27.6 (SD: 6.0) years. Before the COVID-19, 45.0% qualified sperm donors were students, but after the COVID-19, 52.9% were physical laborers (P < 0.05). The proportion of qualified sperm donors with a college education dropped from 80.8 to 64.4% after the COVID-19 (P < 0.05). CONCLUSION Although the sociodemographic characteristics of sperm donors changed after the COVID-19 pandemic, no decline in semen quality was found. There is no concern about the quality of cryopreserved semen in human sperm banks after the COVID-19 pandemic.
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Affiliation(s)
- Wenjun Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, 250012, Jinan, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, 250012, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, 250012, Jinan, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, 250012, Jinan, Shandong, China
| | - Li Wang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, 250012, Jinan, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, 250012, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, 250012, Jinan, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, 250012, Jinan, Shandong, China
| | - Jiwei Sun
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, 250012, Jinan, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, 250012, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, 250012, Jinan, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, 250012, Jinan, Shandong, China
| | - Linlin Cui
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, 250012, Jinan, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, 250012, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, 250012, Jinan, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, 250012, Jinan, Shandong, China
| | - Haobo Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China.,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, 250012, Jinan, Shandong, China.,Shandong Key Laboratory of Reproductive Medicine, 250012, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Reproductive Health, 250012, Jinan, Shandong, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, 250012, Jinan, Shandong, China
| | - Jingmei Hu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China. .,Key laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, 250012, Jinan, Shandong, China. .,Shandong Key Laboratory of Reproductive Medicine, 250012, Jinan, Shandong, China. .,Shandong Provincial Clinical Research Center for Reproductive Health, 250012, Jinan, Shandong, China. .,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, 250012, Jinan, Shandong, China.
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21
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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22
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Tamburrino L, Traini G, Marcellini A, Vignozzi L, Baldi E, Marchiani S. Cryopreservation of Human Spermatozoa: Functional, Molecular and Clinical Aspects. Int J Mol Sci 2023; 24. [PMID: 36902084 DOI: 10.3390/ijms24054656] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
Cryopreservation is an expanding strategy to allow not only fertility preservation for individuals who need such procedures because of gonadotoxic treatments, active duty in dangerous occupations or social reasons and gamete donation for couples where conception is denied, but also for animal breeding and preservation of endangered animal species. Despite the improvement in semen cryopreservation techniques and the worldwide expansion of semen banks, damage to spermatozoa and the consequent impairment of its functions still remain unsolved problems, conditioning the choice of the technique in assisted reproduction procedures. Although many studies have attempted to find solutions to limit sperm damage following cryopreservation and identify possible markers of damage susceptibility, active research in this field is still required in order to optimize the process. Here, we review the available evidence regarding structural, molecular and functional damage occurring in cryopreserved human spermatozoa and the possible strategies to prevent it and optimize the procedures. Finally, we review the results on assisted reproduction technique (ARTs) outcomes following the use of cryopreserved spermatozoa.
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23
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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24
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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25
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Salonia A, Pontillo M, Capogrosso P, Pozzi E, Ferrara AM, Cotelessa A, Belladelli F, Corsini C, Gregori S, Rowe I, Carenzi C, Ramirez GA, Tresoldi C, Locatelli M, Cavalli G, Dagna L, Castagna A, Zangrillo A, Tresoldi M, Landoni G, Rovere‐Querini P, Ciceri F, Montorsi F. Testosterone in males with COVID-19: a 12-month cohort study. Andrology 2023; 11:17-23. [PMID: 36251583 PMCID: PMC9874525 DOI: 10.1111/andr.13322] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/18/2022] [Accepted: 10/11/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Male patients with COVID-19 have been found with reduced serum total testosterone (tT) levels and with more severe clinical outcomes. OBJECTIVES To assess total testosterone (tT) levels and the probability of recovering eugonadal tT levels during a minimum 12-month timespan in a cohort of men who have been followed over time after the recovery from laboratory-confirmed COVID-19. MATERIALS AND METHODS Demographic, clinical and hormonal values were collected for the overall cohort. Hypogonadism was defined as tT ≤9.2 nmol/l. The Charlson Comorbidity Index was used to score health-significant comorbidities. Descriptive statistics was used to compare hormonal levels at baseline versus 7-month (FU1) versus 12-month (FU2) follow-up, respectively. Multivariate cox proportional hazards regression model was used to identify the potential predictors of eugonadism recovery over time among patients with hypogonadism at the time of infection. RESULTS Of the original cohort of 286 patients, follow-up data were available for 121 (42.3%) at FU1 and 63 (22%) patients at FU2, respectively. Higher median interquartile range (IQR) tT levels were detected at FU2 (13.8 (12.3-15.3) nmol/L) versus FU1 (10.2 [9.3-10.9] nmol/L) and versus baseline (3.6 [3.02-4.02] nmol/L) (all p < 0.0001), whilst both LH and E2 levels significantly decreased over the same time frame (all p ≤ 0.01). Circulating IL-6 levels further decreased at FU2 compared to FU1 levels (19.3 vs. 72.8 pg/ml) (p = 0.02). At multivariable cox regression analyses, baseline tT level (HR 1.19; p = 0.03 [1.02-1.4]) was independently associated with the probability of tT level normalization over time, after adjusting for potential confounders. CONCLUSIONS Circulating tT levels keep increasing over time in men after COVID-19. Still, almost 30% of men who recovered from COVID-19 had low circulating T levels suggestive for a condition of hypogonadism at a minimum 12-month follow-up.
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Affiliation(s)
- Andrea Salonia
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Marina Pontillo
- Laboratory Medicine ServiceIRCCS Ospedale San RaffaeleMilanItaly
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,Department of Urology and AndrologyOspedale di Circolo and Macchi FoundationVareseItaly
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Anna Maria Ferrara
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly
| | - Alice Cotelessa
- Laboratory Medicine ServiceIRCCS Ospedale San RaffaeleMilanItaly
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Christian Corsini
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
| | - Silvia Gregori
- San Raffaele Telethon Institute for Gene Therapy (SR‐TIGET)IRCCS Ospedale San RaffaeleMilanItaly
| | - Isaline Rowe
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly
| | - Cristina Carenzi
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly
| | - Giuseppe A. Ramirez
- University Vita‐Salute San RaffaeleMilanItaly,Immunology, Rheumatology, Allergology and Rare Diseases UnitIRCCS Ospedale San RaffaeleMilanItaly
| | | | | | - Giulio Cavalli
- University Vita‐Salute San RaffaeleMilanItaly,Immunology, Rheumatology, Allergology and Rare Diseases UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Lorenzo Dagna
- University Vita‐Salute San RaffaeleMilanItaly,Immunology, Rheumatology, Allergology and Rare Diseases UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Antonella Castagna
- University Vita‐Salute San RaffaeleMilanItaly,Department of Infectious DiseasesIRCCS Ospedale San RaffaeleMilanItaly
| | - Alberto Zangrillo
- University Vita‐Salute San RaffaeleMilanItaly,Anesthesia and Intensive Care DepartmentIRCCS Ospedale San RaffaeleMilanItaly
| | - Moreno Tresoldi
- General Medicine and Advanced Care UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Giovanni Landoni
- University Vita‐Salute San RaffaeleMilanItaly,Anesthesia and Intensive Care DepartmentIRCCS Ospedale San RaffaeleMilanItaly
| | - Patrizia Rovere‐Querini
- University Vita‐Salute San RaffaeleMilanItaly,Internal Medicine, Diabetes, and Endocrinology UnitIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Fabio Ciceri
- University Vita‐Salute San RaffaeleMilanItaly,Hematology and Bone Marrow Transplant UnitIRCCS Ospedale San RaffaeleMilanItaly
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of UrologyURI; IRCCS Ospedale San RaffaeleMilanItaly,University Vita‐Salute San RaffaeleMilanItaly
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Pivonello R, de Angelis C, Menafra D, Colao A. Testis-Specific Genes Deregulation in the Testis of COVID-19 Patients: A Potential Driver of Spermatogenesis Disruption? J Clin Endocrinol Metab 2022; 108:e195-e196. [PMID: 36524343 PMCID: PMC10099156 DOI: 10.1210/clinem/dgac730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
- Unesco Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Cristina de Angelis
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
| | - Davide Menafra
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
- Unesco Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
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Isidori AM, Aversa A, Calogero A, Ferlin A, Francavilla S, Lanfranco F, Pivonello R, Rochira V, Corona G, Maggi M. Adult- and late-onset male hypogonadism: the clinical practice guidelines of the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE). J Endocrinol Invest 2022; 45:2385-2403. [PMID: 36018454 PMCID: PMC9415259 DOI: 10.1007/s40618-022-01859-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/29/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To provide the evidence-based recommendations on the role of testosterone (T) on age-related symptoms and signs remains. METHODS The Italian Society of Andrology and Sexual Medicine (SIAMS) and the and the Italian Society of Endocrinology (SIE) commissioned an expert task force to provide an updated guideline on adult-onset male hypogonadism. Derived recommendations were based on Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. RESULTS Clinical diagnosis of adult-onset hypogonadism should be based on a combination of clinical and biochemical parameters. Testosterone replacement therapy (TRT) should be offered to all symptomatic subjects with hypogonadism after the exclusion of possible contraindications. T gels and the long-acting injectable T are currently available preparations showing the best efficacy/safety profile. TRT can improve all aspects of sexual function, although its effect is limited in more complicated patients. Body composition (reducing fat mass and increasing lean mass) is improved after TRT, either in subjects with or without metabolic syndrome or type 2 diabetes. Conversely, the role of TRT in improving glycometabolic control is more conflicting. TRT can result in increasing bone mineral density, particularly at lumbar site, but no information on fracture risk is available. Limited data support the use of TRT for improving other outcomes, including mood frailty and mobility. CONCLUSIONS TRT can improve sexual function and body composition particularly in less complicated adult and in aging subjects with hypogonadism. When hypogonadism is adequately diagnosed, T appropriately prescribed and subjects correctly followed up, no short-term increased risk of adverse events is observed. Longer and larger studies are advisable to better clarify TRT long-term efficacy/safety profile.
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Affiliation(s)
- A M Isidori
- Department of Experimental Medicine, Sapienza University of Rome - Policlinico Umberto I Hospital, Rome, Italy
| | - A Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - A Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - A Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padua, Italy
| | - S Francavilla
- Andrology Unit, Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Lanfranco
- Division of Endocrinology, Andrology and Metabolism, Humanitas Gradenigo, Department of Medical Sciences, University of Turin, Turin, Italy
| | - R Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università Federico II di Napoli, Naples, Italy
- Staff of UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - V Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Largo Nigrisoli, 2, 40133, Bologna, Italy.
| | - M Maggi
- Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
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Manolache NG, Mjaess G, Diamand R, Albisinni S, Roumeguère T. [Prostate cancer, androgen deprivation, and risk of COVID-19 infection : A systematic review and meta-analysis]. Prog Urol 2022:S1166-7087(22)00396-7. [PMID: 36163317 DOI: 10.1016/j.purol.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Male gender has been shown to be a risk factor for COVID-19 infection, and men are more likely to develop severe disease. The aim of this study was to evaluate the effect of androgen deprivation therapy (ADT) on the incidence of infection and severity of SARS-CoV-2 in prostate cancer patients. METHODS A systematic review and meta-analysis were performed after searching PubMed, Scopus, and ClinicalTrial.org databases, between January 2020 and March 2022. Analyses were interpreted through forest plots for the following parameters: risk of infection, hospitalization, intensive care admission, and SARS-CoV-2-related death, with random or fixed-effects models. RESULTS Fifteen articles were included in the systematic review and ten in the meta-analysis. Seven studies evaluated risk of infection in patients on ADT: OR=1.11 (95 % IC : [0.48-2.58] ; P=0.81). Six studies evaluated the risk of hospitalization in patients on ADT: TDA : OR=1.58 (95 % IC : [0.94-2.64] ; P=0.08). Seven studies evaluated risk of ICU admission in patients on ADT: OR=0.90 (95 % IC : [0.71-1.13] ; P=0.37). Nine studies evaluated mortality risk in patients on ADT: OR=1.07 (95 % IC : [0.61-1.87] ; P=0.82). CONCLUSION ADT does not protect against SARS-CoV-2 in prostate cancer patients, nor does it protect against hospitalization, ICU admission, or mortality. These results remain questionable given the retrospective nature of the majority of studies included in our meta-analysis.
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Kabalkin Y, Bentov Y, Gil M, Beharier O, Jaber S, Moav-Zafrir A, Khwies D, Ben-Meir A, Esh Broder E, Walfisch A, Holzer HEG, Hershko Klement A. Mild COVID-19 Was Not Associated with Impaired IVF Outcomes or Early Pregnancy Loss in IVF Patients. J Clin Med 2022; 11:jcm11185265. [PMID: 36142911 PMCID: PMC9505769 DOI: 10.3390/jcm11185265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Data collection regarding the effects of COVID-19 on reproduction is ongoing. This study examined the effect of COVID-19 on IVF cycle parameters and early pregnancy outcomes. It included two arms: the first compared non-exposed cycles to post-SARS-CoV-2 IVF cycles. Sperm parameters were also compared. The second, prospective arm compared pregnancy outcomes among IVF patients who contracted COVID-19 during early pregnancy to those who did not. None of the patients were vaccinated against SARS-CoV-2. The first arm included 60 treatment cycles of women with confirmed COVID-19, compared to 60 non-exposed cycles (either the same patient before exposure or matched non-exposed patients). The outcomes of the treatment cycles did not differ significantly between exposed and non-exposed groups, including number of oocytes, endometrial thickness, fertilization rate and number of top-quality embryos. In 11 cycles, the male partner had also recently recovered: sperm concentration was lower post-exposure: 6.27 million/mL vs. 16.5 pre-exposure (p = 0.008). In 189 patients with IVF-achieved pregnancies, pregnancy loss and hospital admissions did not differ between exposed and non-exposed groups. IVF treatment outcomes and the rate of early pregnancy loss appears to be unaffected by SARS-CoV-2 disease, despite a minor decline in sperm concentration among recent recoverees.
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Affiliation(s)
- Yossef Kabalkin
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Yaakov Bentov
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
- Correspondence:
| | - Moran Gil
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Ein Kerem-Hebrew University Medical Center, Jerusalem 91220, Israel
| | - Ofer Beharier
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Sireen Jaber
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Arbel Moav-Zafrir
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Dua’ Khwies
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Assaf Ben-Meir
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Ein Kerem-Hebrew University Medical Center, Jerusalem 91220, Israel
| | - Efrat Esh Broder
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Asnat Walfisch
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Hananel E. G. Holzer
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Anat Hershko Klement
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Division of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem 9112102, Israel
- The IVF Unit, Hadassah Mount Scopus-Hebrew University Medical Center, Jerusalem 91240, Israel
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Leanza C, Mongioì LM, Cannarella R, La Vignera S, Condorelli RA, Calogero AE. The Possible Role of SARS-CoV-2 in Male Fertility: A Narrative Review. Endocrines 2022; 3:552-559. [DOI: 10.3390/endocrines3030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The spread of severe acute respiratory syndrome—Coronavirus 2 (SARS-CoV-2) around the world has rapidly sparked the interest of the scientific community to discover its implications in human health. Many studies have suggested that SARS-CoV-2 is directly or indirectly involved in the male reproductive tract impairment. Some evidence supports the possible role of the virus in male infertility. Therefore, this review aims to summarize the relationship between the male urogenital tract, male fertility, and the gonadal hormone profile. The testis is one of the organs with the highest expression of the angiotensin-converting enzyme (ACE) 2-receptor that allows the virus to penetrate human cells. Orchitis is a possible clinical manifestation of COVID-19 and testicular damage has been found on autopsy in the testes of patients who died from the disease. SARS-CoV-2 infection can compromise the blood-testis barrier, favoring testicular damage and the production of anti-sperm autoantibodies. Some studies have detected the presence of SARS-CoV-2 in semen and a high percentage of patients with COVID-19 have altered sperm parameters compared to controls. Finally, lower testosterone levels, higher luteinizing hormone (LH) levels, and decreased follicle-stimulating (FSH)/LH and testosterone/LH ratios suggest primary testicular damage. In conclusion, further studies are needed to evaluate the exact mechanisms by which SARS-CoV-2 affects the male reproductive system and fertility and to evaluate the reversibility of its long-term effects.
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31
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Luddi A, Luongo FP, Dragoni F, Fiaschi L, Vicenti I, Lupetti P, Gentile M, Paccagnini E, Haxhiu A, Ponchia R, Governini L, Zazzi M, Piomboni P. Cellular and Molecular Mechanisms of In Vivo and In Vitro SARS-CoV-2 Infection: A Lesson from Human Sperm. Cells 2022; 11:cells11172631. [PMID: 36078041 PMCID: PMC9455059 DOI: 10.3390/cells11172631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Despite the major target of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, being the respiratory system, clinical evidence suggests that the male reproductive system may represent another viral target organ. Revealing the effect of SARS-CoV-2 infection on testis and sperm is a priority for reproductive biology, as well as for reproductive medicine. Here, we confirmed that the SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) is highly expressed on human testis and ejaculated sperm; moreover, we provide evidence for the expression of the co-receptors transmembrane protease/serine (TMPRSS2), Basigin (BSG), and Catepsin L (CTSL). Human sperm were readily infected, both in vivo and in vitro, by SARS-CoV-2, as demonstrated by confocal and electron microscopy. The demonstration that the seminiferous epithelium and sperm support SARS-CoV-2 viral replication suggests the possibility that the spermatogenetic process may be detrimentally affected by the virus, and at the same time, supports the need to implement safety measures and guidelines to ensure specific care in reproductive medicine.
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Affiliation(s)
- Alice Luddi
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Francesca Paola Luongo
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lia Fiaschi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Pietro Lupetti
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | | | | | - Alesandro Haxhiu
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Rosetta Ponchia
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Laura Governini
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- Correspondence: (L.G.); (M.Z.); Tel.: +39-0577-586810 (L.G.); +39-0577-233863 (M.Z.)
| | - Maurizio Zazzi
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Correspondence: (L.G.); (M.Z.); Tel.: +39-0577-586810 (L.G.); +39-0577-233863 (M.Z.)
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
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Mikacic M, Kumric M, Baricevic M, Tokic D, Stojanovic Stipic S, Cvitkovic I, Supe Domic D, Ticinovic Kurir T, Bozic J. Dynamic of Serum TWEAK Levels in Critically Ill COVID-19 Male Patients. J Clin Med 2022; 11:jcm11133699. [PMID: 35806986 PMCID: PMC9267298 DOI: 10.3390/jcm11133699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 02/04/2023] Open
Abstract
Although the number of cases and mortality of COVID-19 are seemingly declining, clinicians endeavor to establish indicators and predictors of such responses in order to optimize treatment regimens for future outbreaks of SARS-CoV-2 or similar viruses. Considering the importance of aberrant immune response in severe COVID-19, in the present study, we aimed to explore the dynamic of serum TNF-like weak inducer of apoptosis (TWEAK) levels in critically-ill COVID-19 patients and establish whether these levels may predict in-hospital mortality and if TWEAK is associated with impairment of testosterone levels observed in this population. The present single-center cohort study involved 66 men between the ages of 18 and 65 who were suffering from a severe type of COVID-19. Serum TWEAK was rising during the first week after admission to intensive care unit (ICU), whereas decline to baseline values was observed in the second week post-ICU admission (p = 0.032) but not in patients who died in hospital. Receiver-operator characteristics analysis demonstrated that serum TWEAK at admission to ICU is a significant predictor of in-hospital mortality (AUC = 0.689, p = 0.019). Finally, a negative correlation was found between serum TWEAK at admission and testosterone levels (r = −0.310, p = 0.036). In summary, serum TWEAK predicts in-hospital mortality in severe COVID-19. In addition, inflammatory pathways including TWEAK seem to be implicated in pathophysiology of reproductive hormone axis disturbance in severe form of COVID-19.
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Affiliation(s)
- Marijana Mikacic
- Intensive Care Unit of the Department of Internal Medicine, University Hospital of Split, 21000 Split, Croatia; (M.M.); (M.B.)
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (I.C.); (T.T.K.)
| | - Martina Baricevic
- Intensive Care Unit of the Department of Internal Medicine, University Hospital of Split, 21000 Split, Croatia; (M.M.); (M.B.)
| | - Daria Tokic
- Department of Anesthesiology and Intensive Care, University Hospital of Split, 21000 Split, Croatia; (D.T.); (S.S.S.)
| | - Sanda Stojanovic Stipic
- Department of Anesthesiology and Intensive Care, University Hospital of Split, 21000 Split, Croatia; (D.T.); (S.S.S.)
| | - Ivan Cvitkovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (I.C.); (T.T.K.)
| | - Daniela Supe Domic
- Department of Health Studies, University of Split, 21000 Split, Croatia;
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (I.C.); (T.T.K.)
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Split, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (M.K.); (I.C.); (T.T.K.)
- Correspondence:
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