SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

doi:10.1111/andr.12809

. 2021 Jan;9(1):10-18.

doi: 10.1111/andr.12809. Epub 2020 May 22.

SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

Sandro C Esteves^{1

2

3}, Francesco Lombardo⁴, Nicolás Garrido⁵, Juan Alvarez⁶, Armand Zini⁷, Giovanni M Colpi^{8

9}, Jackson Kirkman-Brown^{10

11}, Sheena E M Lewis^{12

13}, Lars Björndahl¹⁴, Ahmad Majzoub^{15

16}, Chak-Lam Cho^{17

18}, Pedro Vendeira¹⁹, Jorge Hallak^{20

21

22

23}, Edouard Amar²⁴, Marcello Cocuzza²⁵, Fabiola C Bento¹, Rita C Figueira¹, Romualdo Sciorio²⁶, Rita J Laursen²⁷, Ahmad M Metwalley^{28

29}, Sunil K Jindal³⁰, Sijo Parekattil³¹, Ranjith Ramasamy³², Carlo Alviggi³³, Peter Humaidan^{3

27}, John L Yovich^{34

35

36}, Ashok Agarwal³⁷

Affiliations

¹ ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil.
² Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, Brazil.
³ Faculty of Health, Aarhus University, Aarhus, Denmark.
⁴ Department of Medical Physiopathology, University of Rome "La Sapienza", Rome, Italy.
⁵ IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
⁶ Centro ANDROGEN, La Coruña, Spain.
⁷ Division of Urology, Department of Surgery, St. Mary's Hospital, McGill University, Montreal, QC, Canada.
⁸ Andrology Service, Procrea Swiss Fertility Center, Lugano, Switzerland.
⁹ Andrology and IVF Department, San Carlo Cinic, Paderno Dugnano/Milano, Italy.
¹⁰ Centre for Human Reproductive Science, IMSR, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
¹¹ Birmingham Women's Fertility Centre, Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK.
¹² Queens University Belfast, Belfast, UK.
¹³ Examenlab Ltd., Belfast, UK.
¹⁴ ANOVA, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
¹⁵ Department of Urology, Hamad Medical Corporation, Doha, Qatar.
¹⁶ Weill Cornell Medicine-Qatar, Doha, Qatar.
¹⁷ Department of Surgery, Union Hospital, Hong Kong, Hong Kong.
¹⁸ S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
¹⁹ Urology/Andrology Unit, Saúde Atlântica, Clínica do Dragão, Porto, Portugal.
²⁰ Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, São Paulo, Brazil.
²¹ Division of Urology, University of São Paulo, São Paulo, Brazil.
²² Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo, Brazil.
²³ Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, São Paulo, Brazil.
²⁴ Cabinet D'Andrologie Victor Hugo, American Hospital of Paris Reproductive Center, Paris, France.
²⁵ Human Reproduction Center, Division of Urology, University of São Paulo, São Paulo, Brazil.
²⁶ Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, Edinburgh, UK.
²⁷ Fertility Clinic Skive, Skive Regional Hospital, Skive, Denmark.
²⁸ IVF Laboratory, Al Saad Specialist Hospitals, Jeddah, Saudi Arabia.
²⁹ Reproductive Medicine and Genetic Unit, GEBRI, Sadat City, Egypt.
³⁰ Division of Reproductive Medicine and Andrology, Jindal Hospital, Meerut, India.
³¹ PUR Clinic and University of Central Florida, Clermont, FL, USA.
³² Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.
³³ Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy.
³⁴ PIVET Medical Centre, Perth, WA, Australia.
³⁵ Curtin University, Perth, WA, Australia.
³⁶ Cairns Fertility Centre, Cairns, QLD, Australia.
³⁷ Andrology Center, Department of Urology, Cleveland Clinic, Cleveland, OH, USA.

PMID: 32357288
PMCID: PMC7267121
DOI: 10.1111/andr.12809

SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

Sandro C Esteves et al. Andrology. 2021 Jan.

. 2021 Jan;9(1):10-18.

doi: 10.1111/andr.12809. Epub 2020 May 22.

Authors

Affiliations

¹ ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil.
² Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, Brazil.
³ Faculty of Health, Aarhus University, Aarhus, Denmark.
⁴ Department of Medical Physiopathology, University of Rome "La Sapienza", Rome, Italy.
⁵ IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
⁶ Centro ANDROGEN, La Coruña, Spain.
⁷ Division of Urology, Department of Surgery, St. Mary's Hospital, McGill University, Montreal, QC, Canada.
⁸ Andrology Service, Procrea Swiss Fertility Center, Lugano, Switzerland.
⁹ Andrology and IVF Department, San Carlo Cinic, Paderno Dugnano/Milano, Italy.
¹⁰ Centre for Human Reproductive Science, IMSR, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
¹¹ Birmingham Women's Fertility Centre, Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK.
¹² Queens University Belfast, Belfast, UK.
¹³ Examenlab Ltd., Belfast, UK.
¹⁴ ANOVA, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
¹⁵ Department of Urology, Hamad Medical Corporation, Doha, Qatar.
¹⁶ Weill Cornell Medicine-Qatar, Doha, Qatar.
¹⁷ Department of Surgery, Union Hospital, Hong Kong, Hong Kong.
¹⁸ S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
¹⁹ Urology/Andrology Unit, Saúde Atlântica, Clínica do Dragão, Porto, Portugal.
²⁰ Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, São Paulo, Brazil.
²¹ Division of Urology, University of São Paulo, São Paulo, Brazil.
²² Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo, Brazil.
²³ Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, São Paulo, Brazil.
²⁴ Cabinet D'Andrologie Victor Hugo, American Hospital of Paris Reproductive Center, Paris, France.
²⁵ Human Reproduction Center, Division of Urology, University of São Paulo, São Paulo, Brazil.
²⁶ Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, Edinburgh, UK.
²⁷ Fertility Clinic Skive, Skive Regional Hospital, Skive, Denmark.
²⁸ IVF Laboratory, Al Saad Specialist Hospitals, Jeddah, Saudi Arabia.
²⁹ Reproductive Medicine and Genetic Unit, GEBRI, Sadat City, Egypt.
³⁰ Division of Reproductive Medicine and Andrology, Jindal Hospital, Meerut, India.
³¹ PUR Clinic and University of Central Florida, Clermont, FL, USA.
³² Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.
³³ Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy.
³⁴ PIVET Medical Centre, Perth, WA, Australia.
³⁵ Curtin University, Perth, WA, Australia.
³⁶ Cairns Fertility Centre, Cairns, QLD, Australia.
³⁷ Andrology Center, Department of Urology, Cleveland Clinic, Cleveland, OH, USA.

PMID: 32357288
PMCID: PMC7267121
DOI: 10.1111/andr.12809

Abstract

The prolonged lockdown of health facilities providing non-urgent gamete cryopreservation-as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS-CoV-2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto-immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the "fertility window" may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries.

Keywords: SARS-CoV-2; azoospermia; male infertility; opinion; semen analysis; sperm banking; systemic auto-immune diseases.

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Conflict of interest statement

SCE and CA declare the receipt of unrestricted research grants and lecture fees from Merck outside the submitted work. SEML is an employee of Examenlab Ltd., a university spin‐out company with a commercial interest in sperm DNA damage. FL, NG, JA, AZ, GMC, JK‐B, LB, AH, C‐LC, PV, JH, EA, MC, FCB, RCF, RS, RL, AMM, SKJ, SP, RR, PH, JLY, and AA declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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SARS‐CoV‐2 pandemic and provision of andrological services: proposal for individualized management

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References

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1. European Society for Human Reproduction and Embryology (ESHRE) . Coronavirus Covid‐19: ESHRE statement on pregnancy and conception. 2020.
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[1] American Society for Reproductive Medicine (ASRM) . American Society for Reproductive Medicine Patient Management And Clinical Recommendations during The Coronavirus (Covid‐19) Pandemic. 2020. https://www.asrm.org/news‐and‐publications/covid‐19/statements/patient‐m... Accessed April 14, 2020.

[2] American Society for Reproductive Medicine (ASRM) . American Society for Reproductive Medicine Patient Management And Clinical Recommendations during The Coronavirus (Covid‐19) Pandemic. 2020. https://www.asrm.org/news‐and‐publications/covid‐19/statements/patient‐m... Accessed April 14, 2020.

[3] European Society for Human Reproduction and Embryology (ESHRE) . Coronavirus Covid‐19: ESHRE statement on pregnancy and conception. 2020.

[4] European Society for Human Reproduction and Embryology (ESHRE) . Coronavirus Covid‐19: ESHRE statement on pregnancy and conception. 2020.

[5] European Association of Urology (EAU) COVID‐19 Recommendations . EAU Guidelines Office Rapid Reaction Group: An organization‐wide collaborative effort to adapt the EAU guidelines recommendations to the COVID era. https://uroweb.org/wp‐content/uploads/Combined‐non‐oncology‐COVID‐recomm... Accessed April 18, 2020. - PMC - PubMed

[6] European Association of Urology (EAU) COVID‐19 Recommendations . EAU Guidelines Office Rapid Reaction Group: An organization‐wide collaborative effort to adapt the EAU guidelines recommendations to the COVID era. https://uroweb.org/wp‐content/uploads/Combined‐non‐oncology‐COVID‐recomm... Accessed April 18, 2020. - PMC - PubMed

[7] COVID‐10 Coronavirus Pandemic . https://www.worldometers.info/coronavirus/ Accessed April 16, 2020.

[8] COVID‐10 Coronavirus Pandemic . https://www.worldometers.info/coronavirus/ Accessed April 16, 2020.

[9] Yu N, Li W, Kang Q,, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID‐19 in Wuhan, China: a retrospective, single‐centre, descriptive study. Lancet Infect Dis. 2020;20(5):559‐564. - PMC - PubMed

[10] Yu N, Li W, Kang Q,, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID‐19 in Wuhan, China: a retrospective, single‐centre, descriptive study. Lancet Infect Dis. 2020;20(5):559‐564. - PMC - PubMed

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SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

Affiliations

SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services

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