ABSTRACT
Several preventive measures, including vaccination, have been implemented owing to the severe global effect of coronavirus disease 2019 (COVID-19), but there is still limited evidence in the effect of this disease and vaccination against it on male fertility. Therefore, this study is to compare sperm parameters of infertile patients with or without COVID-19 infection and the effect of COVID-19 vaccine types on them. Semen samples of infertile patients were collected consecutively at Universitas Indonesia - Cipto Mangunkusumo Hospital (Jakarta, Indonesia). COVID-19 was diagnosed by rapid antigen or polymerase chain reaction (PCR) tests. Vaccination was performed with three types of vaccine, namely inactivated viral vaccine, messenger RNA (mRNA) vaccine, and viral vector vaccine. Spermatozoa were then analyzed on the World Health Organization recommendations, and DNA fragmentation was assayed with the sperm chromatin dispersion kit. The results showed that the COVID-19 group experienced a significant decrease in sperm concentration and progressive motility (both P < 0.05), but there was no significant change in morphology or sperm DNA fragmentation index (DFI; both P > 0.05). The viral vector vaccine caused a decrease in morphology as well as an increase in DFI compared with the control (both P < 0.05), meanwhile results for those who were vaccinated with the inactivated and mRNA types were not significant compared with the control (both P > 0.05). We conclude that COVID-19 has negative effects on sperm parametes and sperm DNA fragmentation, and we found that the viral vector vaccines affect sperm parameter values and DNA fragmentation negatively. Further studies with a larger population and longer follow-up are needed to confirm the results.
ABSTRACT
Background. Several studies have shown the short-term effects of COVID-19 on semen quality, but not as many for the long-term effects. This follow-up study aims to explore the long-term effects of COVID-19 on male fertility by comparing semen parameters of patients recovering from COVID-19 infection. Methods. Fourteen subjects aged >18 years old who had a history of resolved COVID-19 infection with previous evidence of laboratory-confirmed positive SARS-CoV-2 nasopharyngeal PCR swab result, and had a previous history of infertility after COVID-19 infection based on the evidence of the semen analysis within 6 months or longer were recruited in this study. Analysis of the semen parameter of all fourteen subjects was performed, including semen volume, pH, sperm concentration, total, progressive, non-progressive, and immotile motility percentage, morphology percentage, leukocyte, erythrocyte, and immature sperm cells parameters. The semen analysis obtained from this current semen analysis was compared with individual baseline semen analysis results, which were obtained in the resolution phase of COVID-19 infection, 6 months or longer from the current semen analysis. Results. Mean pH decreased significantly in follow-up semen analysis, with baseline vs. follow-up 7.9 vs 7.4 (p=0.002;95%CI=0.3-0.67). Mean sperm concentration also decreased significantly, with baseline vs. follow-up 78.5 million/mL vs. 37.4 million/mL (p=0.013;95%CI=7.5-74.5). Lastly, mean immature sperm count is also decreased significantly, with baseline vs. follow-up 2.5 million/mL vs. 0.4 million/mL (p=0.006;95%CI=0.37-4.03). No significant difference was documented for other semen parameters. Conclusion. After 6-7 months of recovery from COVID-19 symptoms, follow-up semen analysis showed reduced sperm pH, sperm concentration, and immature sperm count. These findings indicate that COVID-19 infection could have a longer-term impact on male infertility. © 2022 Universidad Tecnica de Manabi. All rights reserved.