COVID-19: Does The Coronavirus Affect Male Fertility?

Amritha K

According to recent reports by WHO, there are 5,518,661 COVID-19 cases around the world, with 346,979 deaths. On a hopeful note, 2,311,255 have recovered. The need to find a vaccine or a possible medicine that could treat the coronavirus is significant.

Researchers and health experts are ardently focused on studying the novel coronavirus, where new findings and understanding help in the better management of the diseases, and also pave way for the development of an effective vaccine.

By focusing on the reported symptoms and risk factors, researchers are carrying out symptoms related studies, where factors such as obesity, smoking, diabetes, air pollution etc. have been explored [1].

A recent study has explored the effect the coronavirus has on male fertility, as previous reports that lacked proof had claimed that the virus can impact male fertility. However, the claims were initially rebuffed due to the lack of evidence.

Does COVID-19 Damage Male Fertility?

There have been reports suggesting that the SARS-CoV-2 can impact male fertility as seasonal cases of flu are known to reduce male fertility, which is due to the fact that the fever associated with the illness overheats the testicles [2].

  • High fever may affect fertility: As the primary and central symptom of the coronavirus infection is a high fever, it was assumed that men infected with coronavirus will also experience reduced fertility [3].
  • Changes in reproductive hormones but not testosterone levels: A study conducted in China pointed out that men with COVID-19 seem to have changes in levels of some of their reproductive hormones compared to men without the virus. However, there was no difference in testosterone levels [4].
  • The link between SARS and COVID-19: In the initial stages, scientists had pointed out that since the novel coronavirus and SARS are genetically similar, it is possible that the novel coronavirus' potential to impact male fertility because SARS causes orchitis and damage to the testicles [5]. But this statement was retracted because no documented cases of testicular infections have been noted during the COVID-19 pandemic [6].

In conclusion, and with current knowledge, researchers had asserted that while it may be a possibility, there is no definitive answer as of now.

"At present, it is somewhat premature to conclude [that] COVID-19 will definitely affect male fertility. But it is useful that the authors have raised this concern," added one of the researchers working on the development of the COVID-19 pandemic [7].

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How Is COVID-19 Linked To Male Infertility?

The focus on the possible link between COVID-19 and male infertility was pointed out by a Professor in reproductive medicine from Wuhan, who suggested that "the coronavirus could affect the testes and that men who have had it should have fertility tests after recovery" [8].

Due to the lack of proof, the report was removed but it can be pointed out that the claims were made due to the following reasons:

  • The protein (ACE2) thought to be used by the novel coronavirus to enter cells (called ACE2) is found in the testes also [9].
  • Possibility of testes being infected and might affect sperm production.
  • Studies had pointed out that SARS, which was also caused by a coronavirus, had led to damage to the testes [10].

Another recent study pointed out that "SARS-CoV-2 can be present in the semen of patients with COVID-19, and SARS-CoV-2 may still be detected in the semen of recovering patients" [11]. However, this is no cause for concern because certain viruses can live in the male reproductive tract, even after recovery [12].

Note: There is currently no evidence that suggests the virus can be transmitted sexually.

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On A Final Note…

In conclusion, researchers are still conducting studies to find if/any links between the COVID-19 infection and male infertility.

"From my own experience...I can confirm that there are a number of methodological challenges to overcome in order to truly establish the source of infection with virus or bacteria within the male reproductive tract, and moreover that any DNA/RNA represents enough virus or bacteria which are sufficient to cause infection by sexual contact," added the researcher.

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