Covid-19 may reduce male fertility, says study

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A review article published Friday (29), in the scientific journal Reproduction, brought yet another adverse effect on men who have already contracted covid-19: the disease is capable of negatively affecting sperm quality and reducing male fertility.

The study’s author, Behzad Hajizadeh Maleki, a doctoral student at Justus Liebig-University in Germany, said in a press release that these effects tend to improve over time, but “remained significantly and abnormally higher in covid-19 patients” who were part of of the study carried out.

The analysis was performed in two populations, one with 84 men with confirmed covid-19 cases, and a control group with 105 healthy men of the same age. After a 60-day follow-up, performed at 10-day intervals, there was an increase in the death of sperm, inflammation and oxidative stress.

Although performed in a small population, this was the first direct experimental evidence that the male reproductive system can be affected and damaged by the coronavirus. The work also serves as an alert for the evaluation and monitoring of reproductive function in men infected with covid-19.

Strong note of caution

For the director of embryology at CARE Fertility Group in Great Britain, Alison Campbell, “there is still no definitive evidence of long-term damage caused by COVID-19 to sperm or the male reproductive potential”.

For the British doctor, the results may have been contaminated by the fact that the men who had covid-19 and recovered were treated with corticosteroids and antiviral therapies, while the control group was not.

An expert in male reproductive medicine at the University of Sheffield, Allan Pacey recommended a “strong note of caution” about the way the research data was interpreted. He warns that some of the factors that caused the reduction in sperm quality may be extra-covid, as 19 individuals were obese.

Pacey warns that the simple fact that one of the groups is very ill, regardless of the cause, needs to be taken into account, considering that any feverish condition can affect sperm production.

More extensive future studies

Another important conclusion presented by the study was the increase in ACE2 enzyme activity in men who had covid-19. This increase is significant, as this enzyme is a protein that provides the entry point for the new coronavirus to connect and infect a wide range of human cells.

Allan Pacey, who is also editor-in-chief of Human Fertility magazine, recognizes that this could be proof that covid-19 can really impact the male reproductive system because the ACE2 receptors that the virus uses to access the lungs are of the same type those found in the testicles.

What all experts agree is that, given the seriousness of the conclusions presented, there is a need for more extensive studies, with more detailed monitoring, as well as monitoring possible transgenerational effects in the long term.

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