Fertility preservation during the COVID-19 pandemic: mitigating the viral contamination risk to reproductive cells in cryostorage

Adiga, Satish Kumar; Tholeti, Prathima; Uppangala, Shubhashree; Kalthur, Guruprasad; Gualtieri, Roberto; Talevi, Riccardo

doi:10.1016/j.rbmo.2020.09.013

Cited by 18 publications

(17 citation statements)

References 69 publications

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“…To employ these strategies for COVID-19 patients, extra precautionary measures should be undertaken during the handling of semen to reduce the chances of viral transmission [ 85 ]. Some of the measures for the elimination of the risk of cross-contamination and transmission through cryobanking services include testing both partners for SARS-CoV-2 before initiating treatment, use of closed-carrier cryodevices and sanitary cryostorage protocols [ 86 ]. Some embryologists have advocated placing all new cryopreserved specimens into a quarantine tank until patients are determined to have negative viral test results at some future time, especially when dealing with donor semen.…”

Section: Sars-cov-2 and Male Fertilitymentioning

confidence: 99%

“…Some embryologists have advocated placing all new cryopreserved specimens into a quarantine tank until patients are determined to have negative viral test results at some future time, especially when dealing with donor semen. Furthermore, all gametes and embryos should go through extensive washing to dilute out potential viral contamination to reduce the possibility of contamination with SARS-CoV-2 [ 86 , 87 ]. The use of high-security straws may also minimize the risks associated with cryopreserving sperm during the pandemic.…”

Section: Sars-cov-2 and Male Fertilitymentioning

confidence: 99%

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Viral pathogenesis of SARS-CoV-2 infection and male reproductive health

et al. 2021

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Coronavirus disease 2019 (COVID-19) has emerged as a new public health crisis, threatening almost all aspects of human life. Originating in bats, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted to humans through unknown intermediate hosts, where it is primarily known to cause pneumonia-like complications in the respiratory system. Organ-to-organ transmission has not been ruled out, thereby raising the possibility of the impact of SARS-CoV-2 infection on multiple organ systems. The male reproductive system has been hypothesized to be a potential target of SARS-CoV-2 infection, which is supported by some preliminary evidence. This may pose a global threat to male fertility potential, as men are more prone to SARS-CoV-2 infection than women, especially those of reproductive age. Preliminary reports have also indicated the possibility of sexual transmission of SARS-CoV-2. It may cause severe complications in infected couples. This review focuses on the pathophysiology of potential SARS-CoV-2 infection in the reproductive organs of males along with their invasion mechanisms. The risks of COVID-19 on male fertility as well as the differences in vulnerability to SARS-CoV-2 infection compared with females have also been highlighted.

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Section: Sars-cov-2 and Male Fertilitymentioning

confidence: 99%

Section: Sars-cov-2 and Male Fertilitymentioning

confidence: 99%

Viral pathogenesis of SARS-CoV-2 infection and male reproductive health

et al. 2021

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“…However, it may be important to perform a Covid screening during fertility treatment, for which there are already guidelines for conduct for fertility care, identified and summarized in the study of Papathanasiou (34) For patients who are interested in sperm cryopreservation, some rules should be followed. Adiga SK (35) illustrated that the measures aimed at minimizing the risk of viral contamination in sperm cryopreservation are: blood tests before starting treatment, fully follow the correct protocols of cryopreservation and proper washing of gametes and embryos during preservation with sterile LN2. Although in some studies the virus has been identified in the testes and there is significant evidence of hypogonadism and hypotestosteronemia, further data is needed to better understand the effects of this virus on reproductive organs, to identify how the virus eventually affects fertility parameters and to ensure that the testis is not a virus reservoir (36).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and male fertility: Taking stock of one year after the outbreak began

Fave

Polisini

Giglioni

et al. 2021

Arch Ital Urol Androl

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Objectives: The aim of this review is to summarize, following a timeline, the current knowledge regarding the effects of the Sars-cov2 virus on male fertility, researching the pathological and clinical results of the studies published in the last year. Methods: A systematic research was performed on the major international online databases; Thirty-five articles were selected. Results: A statistically significant reduction in testosterone levels and sperm quality in subjects with COVID-19 has been highlighted in several papers; however, in many cases the tests have been conducted in patients with active disease and long-term consequences are still not known. Some studies have confirmed the presence of the virus in the testis in a low percentage of patients; viral presence in sperm has only been found in one study. Testicular discomfort, which could indicate viral orchitis, was highlighted in several works, with an incidence of up to 19% percent of patients. The presence of inflammatory lymphocytic infiltrates, IgG and inflammatory cytokines have been documented in several works; pathological signs of inflammation were found in 60.9% of testicular biopsies performed in one study. The entry of the virus into the testis cells, both stromal and seminal cells appeared to be Angiotensin Converting Enzyme-2 (ACE2) mediated, as it also occurs in other tissues. DNA fragmentation, reactive oxygen species (ROS) formation, autoantibody production and ACE2 mediated effect have all been hypothesized as cause of cellular damage. Conclusions: The results on effects of COVID-19 infection on the male reproductive system are currently insufficient as they are based on a small number of patients and therefore are often contradictory.Certain mechanisms of testicular damage are still to be assessed, as any risk categories like age, ethnicity, or others. As for the transmission of the virus through sperm, there is insufficient evidence to ensure that this cannot happen.

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“…Recently, Adiga and colleagues reviewed the question of how to mitigate viral contamination risk, with reference to the cryopreservation of reproductive cells. They concluded that cryostorage using LN 2 may involve the risk of cross-contamination by viral pathogens, suggesting the adoption of strategies to prevent the possible impact of the COVID-19 pandemic [ 20 ]. Further caution is suggested by the study of Lee et al They observed that 1–5 μm aerosol mist particles form 10–20 cm above the LN 2 –air interface, probably due to condensation, evaporation, and floating of particles.…”

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confidence: 99%