[Source – news-medical]
A recent study published in the journal PLOS ONE has revealed that COVID-19 reduces male fertility by affecting semen quality and reproductive hormone levels. Researchers conducted a systematic review and meta-analysis to evaluate the effects of SARS-CoV-2, the virus responsible for COVID-19, on male reproductive health. The virus infects human cells by binding to the angiotensin-converting enzyme-2 (ACE-2) receptor, which is found in various organs, including the lungs, kidneys, heart, and testes. While the respiratory system is primarily affected, studies have shown that COVID-19 also adversely impacts other organ systems, including the male reproductive system.
Data on the effects of SARS-CoV-2 on male fertility have been mixed, with some research associating that COVID-19 reduces male fertility, lower testosterone levels, and worse sperm quality. To address these inconsistencies, the researchers conducted a comprehensive analysis by comparing semen quality variables and reproductive hormone levels between men infected with SARS-CoV-2 and those uninfected. They used the PECO model (Population, Exposure, Comparator, Outcomes) to select studies involving male patients of reproductive age exposed to the virus. The review included both prospective and retrospective studies with appropriate control groups or pre- and post-pandemic data.
Findings from the Meta-Analysis
The meta-analysis reviewed 40 studies conducted across 12 countries between 2020 and 2023, examining the impact of COVID-19 on male reproductive health. The researchers analyzed key semen parameters, such as sperm count, concentration, morphology, motility, and viability, as well as levels of reproductive hormones like testosterone, estrogen, prolactin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). The study found that COVID-19 was significantly associated with a decrease in ejaculate volume and sperm concentration, with no improvements observed after treatment for COVID-19. Sensitivity analyses confirmed that the reduction in ejaculate volume remained consistent, although the difference before and after treatment was not statistically significant.
COVID-19 was also found to reduce sperm motility and viability. Although no significant differences were found in sperm morphology between infected and uninfected men, changes within individuals suggested that SARS-CoV-2 might subtly affect sperm morphology. Moreover, the study noted alterations in reproductive hormone levels, with increased prolactin and slightly higher estrogen levels in infected men. However, testosterone levels showed substantial variability, indicating a more complex impact of COVID-19 on this hormone. Interestingly, leukocyte levels in seminal fluid remained similar between infected and uninfected men.
Implications and Future Research Directions
The study concludes that COVID-19 has a substantial negative impact on male fertility, particularly concerning semen parameters like ejaculate volume, sperm count, concentration, motility, and viability. While treatment for COVID-19 showed some improvement in affected parameters, these changes were often insufficient to restore pre-infection levels. For instance, sperm concentration and motility remained significantly reduced even after recovery. The findings underscore the need for further research to better understand the long-term effects of COVID-19 on male reproductive health and to explore potential therapeutic interventions that may help mitigate these effects.
Overall, this study adds to the growing body of evidence indicating that COVID-19 reduces male fertility, which could have far-reaching consequences beyond its respiratory impact, particularly for male fertility. The authors emphasize the importance of continued investigation into the long-term consequences of COVID-19 on reproductive health and encourage healthcare professionals to consider these findings in managing male patients recovering from the virus.
