Male Fertility and the COVID-19 Pandemic: Systematic Review of the Literature

Abstract

, the novel coronavirus SARS-CoV-2 has spread globally, causing the current COVID-19 (coronavirus disease-19) pandemic. As there is an increase of infections in the male population, concerns have emerged about the potential impact of COVID-19 on male reproductive organs and male fertility. Therefore, this study systematically investigates the current evidence of SARS-CoV-2 impact on male reproduction and pregnancy outcomes, discussing them in light of the evidence published on other coronaviruses. Materials and Methods: Materials and Methods: Literature search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 24 original articles were included for the analysis, investigating the effects of the infection on semen parameters, male reproductive hormones, and pregnancy outcomes. Further, a Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis was conducted based on the available evidence linking the virus with male reproduction and conception. Results: Results: Although there is limited data, viral mRNA has been identified in semen of infected men, with some evidence of altered seminal parameters. Low testosterone and dihydrotestosterone with raised luteinizing hormone has been reported as well as preterm delivery in pregnant women; however, data regarding vertical transmission remains contradictory and inconclusive. Conclusions: Conclusions: The recent literature provides evidence that male gonads may be potentially vulnerable to SARS-CoV-2 infection, recommending caution to pregnant women and couples planning natural pregnancy or assisted reproduction.

Semen Does Not Cause Additional Risk for SARS-CoV-2 Transmission during Sexual Contact

“…Our study argues that there is probably no additional transmission risk via semen. The available data also support our study that SARS-CoV-2 is not a sexually transmitted virus [4-8]. However, sexual contact carries a high risk in terms of SARS-CoV-2 transmission between partners through the respiratory secretions, not semen.…”

A comprehensive review of the impact of COVID-19 on human reproductive biology, assisted reproduction care and pregnancy: a Canadian perspective

“…Furthermore, hypogonadism is a common finding in systemic illnesses. In the case of COVID-19, it is unknown yet whether the low T levels observed are the result of a direct effect by COVID-19 on gonadal function by a non-specific result of a severe systemic illness [50,53]. Follow up and evaluation of reproductive function in recovering patients is required to assess the duration of these effects after recovery.…”

Effect of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) on reproductive system

“…S1 and S2: S domain; PD: peptidase domain; RBD: receptor-binding domain. ( Fan et al, 2020 , Illiano et al, 2020 , Khalili et al, 2020 , Kumar et al, 2020 , Rasmussen et al, 2020 ) …”