According to published research by Chinese scientists, human testicles are a potential target for the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus. The researchers found that the ACE2 receptor, through which this virus enters cells, is highly expressed in the testes.
We decided to check this assumption, which appeared on the page of the press center of the Human Stem Cell Institute. In addition, a lot of disinformation is circulating on this topic in social networks.
We reviewed scientific articles on the subject and interviewed doctors. We need to note that many doctors refused to comment on this topic.
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Among those who agreed to answer our questions was urologist, andrologist Elena Novikova. Elena is a specialist from Novosibirsk, she twice won the title of the best andrologist in the region (2020, 2021). She is also a researcher at the Federal Research Center for Fundamental and Translational Medicine. Elena was immediately attracted by the topic of the interview, she considers it relevant and requiring detailed analysis.
When asked if she had any cases in recent practice when patients had complications with the reproductive system after coronavirus disease, she immediately replied:
-Yes there were. Of course, male fertility has deteriorated significantly during the pandemic. Even without conducting rigorous analytics and research, you can see that at the moment more than 50% of men come to the appointment with the problem of changing ejaculates, most often when the process is already in a severe form. At our institute, we conducted research and found that there are negative consequences after suffering from a coronavirus disease. They affect both fertility and the hormonal background of a man: the level of testosterone decreases, new diseases appear, associated precisely with the effect of the virus on the tissues and organs of the body. Including postcoid orchopididymitis, which develops at a delayed stage, not immediately. That is, edema of the genitals does not occur immediately, but in a delayed perspective. At the moment, we continue to conduct clinical studies and research.
The founder of the Institute of Human Stem Cells Artur Isaev also agreed to comment on the problem. He states that at present there is no well-proven information that in reality the reproductive function suffers from the coronavirus more than from another respiratory viral disease. He focuses on the fact that not only coronavirus, but also any other respiratory viral diseases can cause complications of reproductive function. According to him, the Human Stem Cell Institute plans to conduct two studies among asymptomatic coronavirus patients and among those who died against the background of coronavirus in order to put an end to the question: “Can coronavirus directly affect infertility in men.” At the same time, he stressed that the scientists of the Institute will equally consider the groups of people who have had asymptomatic illness and with pronounced symptoms: “Since it is asymptomatic, this means without consequences for any organs and systems, this is subject to study, and many researchers are studying it.”
The problem of male infertility is outlined in the study “Male infertility: before and after the era of the coronavirus SARS-CoV-2″ (2020). This article provided examples of how the coronavirus affects male infertility.
1. In a study C. Song et al. collected 12 semen samples from surviving Covid-19 patients, and also took a testicle biopsy from a deceased Covid-19 patient: no SARS-CoV-2 virus RNA was found in the sperm samples and testicular biopsy in the tissues. These results may indicate that the virus, even in the acute phase, is not able to directly infect a man’s testicles or genital tract.
2. In May 2020, data from another study was published . The authors recruited all men over 15 years of age with a confirmed COVID-19 diagnosis and asked them to provide a semen sample for SARS-CoV-2 testing. A total of 38 patients were included in the study for semen testing: it was performed by real-time PCR. 23 (60.5%) participants achieved clinical recovery, and 15 (39.5%) were in the acute stage of infection. It was found that 6 (15.8%) participants had positive results for SARS-CoV-2: including 4 out of 15 (26.7%) patients who were in the acute stage of infection, and 2 out of 23 ( 8.7%), who had a complete recovery (coronavirus was detected even with negative PCR tests from the pharynx). However, there was no significant difference in the negative and positive sperm test groups for SARS-CoV-2 by age, history of urogenital disease, days of illness onset and days after hospitalization.The researchers concluded that the SARS-CoV-2 virus may be present in the semen of patients with COVID-19 and remains for some time in the semen of patients who have recovered.
Almost simultaneously by the world’s leading ART societies (Assisted Reproductive Technologies) on March 17, 2020 American Society for Reproductive Medicine (ASRM) , on April 2, 2020 by the Russian Association for Human Reproduction (RAHR) and on April 23, 2020 by the European Society for Human Reproduction and Embryology (ESHRE) decided to suspend ART procedures for the duration of the pandemic. This was done due to the fact that the effect of SARS-CoV-2 on gametes, embryos and early pregnancy is not fully understood.
Conclusion: There is no exact answer to the question of whether the coronavirus causes male infertility. Coronavirus can be found in the semen of patients and can be stored there, but whether this factor affects infertility or not is not known for certain.
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RESEARCH | ARTICLE © Elena Kaveshnikova, Alina Gabdrakhmanova, Irina Rzhendinskaya, Maria Serchuk, Bizualm Desta, Vlada Nedotko, South Ural State University
