In a latest research printed within the journal PLOS ONE, researchers carried out a scientific assessment and meta-analyzed knowledge on the influence of coronavirus illness 2019 (COVID-19) on male reproductive hormones and semen variables to find out whether or not extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections had an antagonistic influence on male fertility.
Background
The etiological agent of the COVID-19 pandemic, SARS-CoV-2, is a β-coronavirus that infects human cells by binding to the angiotensin-converting enzyme-2 (ACE-2) receptor. The ACE-2 receptor is discovered within the lungs, kidneys, coronary heart, and testes, making all these organs attainable entry factors for the virus.
The COVID-19 pandemic was chargeable for over 700 million instances and greater than 7 million deaths. Nonetheless, though the virus is understood to primarily infect the respiratory system, analysis signifies that it will possibly additionally adversely influence different organ techniques. Research have additionally discovered that SARS-CoV-2 infections are extra extreme in males than in females. Moreover, research have discovered that many males who had been contaminated with the sooner SARS-CoV-1 had developed orchitis or irritation of the testes.
Nonetheless, the info on the influence of SARS-CoV-2 on male reproductive well being has been restricted. Though some research have reported associations between COVID-19 and decreased testosterone ranges and decrease semen high quality, among the findings have been thought of methodologically weak.
Concerning the research
The current research aimed to comprehensively assessment latest research inspecting the influence of COVID-19 on male fertility and carried out a meta-analysis by evaluating semen high quality variables and reproductive hormone ranges between contaminated and uninfected males to know the affect of SARS-CoV-2 on male fertility.
The researchers used the PECO, or Inhabitants, Publicity, Comparator, and Outcomes, mannequin to pick research that examined male sufferers of reproductive age who had been uncovered to SARS-CoV-2. The assessment included each potential and retrospective research so long as they included COVID-19-negative controls or contained pre- and post-COVID-19 pandemic well being knowledge for a similar particular person. Research that had been in vitro, targeted on feminine sufferers, or missing management teams had been excluded.
For the research included within the assessment, the outcomes consisted of measurements of typical semen parameters comparable to sperm rely, ejaculate quantity, sperm focus, morphology, motility, and viability of the sperm, in addition to leukocyte ranges within the seminal fluid. The outcomes additionally included the degrees of the male reproductive hormones, together with testosterone, estrogen, prolactin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). The Measurements additionally included ratios of testosterone to LH and FSH to LH.
For the meta-analysis, the info extracted from the research consisted of pattern sizes, nation of research, research design, the strategies used to diagnose COVID-19, and key outcomes. The researchers used this knowledge to calculate standardized imply variations, with in depth sensitivity analyses to keep away from bias and assess sources of variety. The parameters had been additionally in contrast for modifications earlier than and after therapy for COVID-19.
Outcomes
The assessment recognized 40 eligible research printed from 12 totally different nations between 2020 and 2023 that examined the influence of SARS-CoV-2 on male reproductive well being. The important thing findings from the meta-analysis coated the influence of COVID-19 on a number of features of male reproductive well being.
The research discovered that COVID-19 was considerably related to decreased ejaculate quantity, with sensitivity analyses confirming constant reductions in ejaculate quantity after SARS-CoV-2 infections. Nonetheless, the sensitivity analyses confirmed that the distinction in ejaculate quantity earlier than and after COVID-19 therapy was not statistically vital, indicating that the influence of therapy could also be restricted. The sperm counts additionally decreased after SARS-CoV-2 infections, though the sensitivity analyses indicated that these reductions had been marginal.
People contaminated with SARS-CoV-2 additionally confirmed considerably decrease sperm concentrations, and no modifications had been seen in sperm concentrations after therapy for COVID-19. This discovering remained constant even after accounting for potential research biases and variety, reinforcing the robustness of the consequence. COVID-19 was additionally discovered to decrease sperm viability and motility, with the distinction in sperm viability remaining constant even after the sensitivity evaluation.
Comparisons between contaminated and uninfected people revealed no vital variations in sperm morphology. Nonetheless, comparisons of sperm morphology in the identical particular person earlier than and after SARS-CoV-2 infections revealed decrease ranges of morphologically regular sperm. The evaluation confirmed that whereas the general morphology variations between contaminated and uninfected people weren’t vital, the within-individual modifications counsel that SARS-CoV-2 might have a delicate however noteworthy impact on sperm morphology.
The reproductive hormone ranges had been additionally considerably altered in COVID-19 sufferers, with elevated prolactin and marginally larger estrogen ranges in contaminated males. Curiously, the research discovered substantial variability in testosterone ranges earlier than and after therapy, suggesting that COVID-19’s influence on this hormone could also be extra complicated than initially understood. Nonetheless, the leukocyte ranges within the seminal fluid had been related between contaminated and uninfected males.
Conclusions
To summarize, the research reviewed and carried out a meta-analysis of research inspecting the influence of COVID-19 on male reproductive well being and located that SARS-CoV-2 had a major destructive influence on male fertility, notably on parameters comparable to ejaculate quantity, viability, and motility of the sperm, and sperm focus and rely. Though the therapy of COVID-19 partially alleviated among the affected parameters, the findings counsel that these enhancements might not be ample to revive pre-infection ranges, notably for parameters like sperm focus and motility. The research additionally highlighted the necessity for additional analysis to completely perceive the long-term results of COVID-19 on male fertility and to discover potential therapeutic interventions.
Journal reference:
- V. J., Ashonibare, P. J., Ashonibare, T. M., Akhigbe, & E, A. R. (2024). SARS-CoV-2 impairs male fertility by focusing on semen high quality and testosterone stage: A scientific assessment and meta-analysis. PLOS ONE, 19(9), e0307396-. DOI:10.1371/journal.pone.0307396, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0307396