ABSTRACT
Background and objectives: Since the outbreak of COVID-19, more and more studies have proved that it has an impact on the male reproductive system. The purpose of this article is to investigate the effects of COVID-19 on male semen parameters, further analyze the incidence and risk factors of diseases related to semen parameters, and put forward to corresponding preventive measures. Methods: Retrieved from PubMed, Embase, The Cochrane Library, Web of Science, Clinicaltrails, CNKI, CBM, Wanfang Database and VIP to collect research on the effects of COVID-19 on the male reproductive system. The literature search was conducted until January 2022. In strict accordance with the inclusion and exclusion criteria, two researchers independently screened the literature and comprehensively analyzed five cohort studies on the impact of COVID-19 on male reproductive system. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included cohort studies, and Revman 5.4.1 was applied for statistical analysis. Results: Semen volume (RR = -0.10; 95% CI: 0.45, 0.26; P = 0.60), there was no significant difference between the test group and the control group; Sperm count (RR = -45.28; 95% CI: 66.38, 24.19; P = 0.0001), the sperm count of the COVID-19 test group was lower than that of the control group, and the difference was statistically significant; Sperm concentration (RR = -15.65 × 106; 95%CI: 31.52 × 106, 0.21 × 106; P = 0.05), there was no significant difference between the test group and the control group; progressive sperm motility (RR = 4.31; 95% CI: 4.62, 13.24; P = 0.34), there was no effect on progressive sperm motility in the COVID-19 test group compared with the control group. Conclusions: COVID-19 can reduce semen quality and affect male fertility. However, due to the limitations of this study, this conclusion needs to be further verified by large-sample, high-quality prospective cohort studies on the long-term effects of COVID-19 on male reproductive function.
ABSTRACT
Background: Although the negative impact on fertility of men recovered from coronavirus disease 2019 (COVID-19) has been suggested, there is insufficient evidence, and the data are limited and contradictory. The present prospective study aimed to evaluate the sex-related hormones, semen parameters, erectile dysfunction (ED), and lower urinary tract symptoms (LUTS) in a cohort of men who recovered from COVID-19 and age-matched control men. Methods: Semen samples were collected from twenty-two men recovered from COVID-19 with a median time of 91.5 days and thirty-six control males. The semen parameters were evaluated according to the World Health Organization (WHO) laboratory manual to examine and process human semen. The blood samples were collected to assess the male hormone profile. ED and LUTS were evaluated with the International Index of Erectile Function 5 (IIEF-5) and the International Prostate Symptom Score (IPSS), respectively. Results: The follicle-stimulating hormone (FSH) (3.819±1.515 IU/L), luteinizing hormone (LH) (4.023±1.792 IU/L), prolactin (PRL) [12.60 (10.72-15.20) ng/mL], and testosterone (T) [4.345 (3.565-5.525) ng/mL] levels were at normal range in all males enrolled in the study. Levels of semen volume (control: 2.5 mL vs. COVID-19: 1.9 mL; P<0.05) and sperm concentration (control: 59×106/mL vs. COVID-19: 41.5×106/mL; P<0.005) were significantly lower in males recovered from COVID-19, but still technically well within normal regardless of WHO edition. All variables were examined through logistic regression analysis, demonstrating that only sperm concentration was an independent variable associated with men recovered from COVID-19 [odds ratio (OR) =1; 95% confidence interval (CI): 0.999-1.098; P=0.016]. According to correlation analysis, there was no correlation between sperm concentration and other semen parameters and sex-related hormone profiles. Furthermore, an absence of ED and LUTS in men who recovered from COVID-19 was evidenced using the IIEF-5 and IPSS, respectively. Conclusions: Reproductive-age males recovered from COVID-19 have normal sperm concentration. Sperm concentration did not correlate with other semen parameters, sex-related hormones, IIEF-5, and IPSS. Further studies should be performed to evaluate whether the lower sperm concentration and semen volume that were still within the normal range are a transient or prolonged downregulation resulting from the COVID-19 attack.
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.