COVID–19 and Male Infertility
Not so long time ago, the information that coronavirus leads to male infertility appeared in a worldwide network. In society, the news has resonated around the world. We have found publications on this subject in the reputable journal ‘Fertility and sterility’. The work was written by Michael L. Eisenberg, MD, Department of Urology, Stanford University of California. As well as recent publications by Chinese scientists.
‘The SARS–Cov–2 virus is found in the secretions from the nose, sputum, feces, and blood of infected people, but not in the urine. Neurological, cardiac, and ocular symptoms have already been reported, but the reproductive effects are not yet known.’
Since the male half, according to statistics, is more susceptible to coronavirus, attention has shifted to their potential genetic susceptibility. Scientists note a similar effect on the body of COVID–19 and SARS viruses.
Both penetrate the same cell receptor, ACE2. SARS viral infection could theoretically lead to immune damage to the male reproductive system, causing orchitis affects sperm production and synthesis of androgens.
Therefore, there was concern regarding:
●testicular infection,
●possible sexual transmission of the virus.
Among the 34 men who were examined, no SARS–Cov–2 was detected in semen, using RT–PCR. This is an encouraging fact regarding the transmission of the virus. But it is important to note that the studied men often had only mild symptoms. Perhaps the early stages of infection and higher viral loads will lead to other consequences.
Taking into account the known mechanisms of SARS–Cov–2 penetration into cells and the need for double expression of ACE and TMPRSS2 proteins, the authors showed that only 4 of 6490 (<0.1%) testicular cells contain RNA for both proteins. Thus, it seems unlikely that SARS–Cov–2 can penetrate into any testicle cells (e.g., germ cells, Leydig cells, Sertoli cells, etc.), as was suggested.
Further, the authors reported a new clinical observation. 17.6% (6/34) of men reported discomfort in the scrotum during Covid–19 infection.
These new observations set the vector for future screening. In the current report, it was noted that there was no opportunity to assess changes in sperm quality among participants. Therefore, it remains unknown whether fertility will be impaired among infected men.
Evidence for other febrile illnesses has shown that an acute period and fever can temporarily reduce spermatogenesis. Whether COVID 19 will follow this model remains to be seen.
In addition, 80% of those infected with coronavirus have no symptoms. This means that the reproductive consequences for these men are likely to be favorable, but so far remain unknown.
According to the Sechenov University Institute of Urology and Human Reproductive Health, it was established: ‘no symptoms of severe testicular damage were found in patients with SARS. Not a single person reported on developed infertility.’