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Review
. 2021 Jul;9(4):1027-1037.
doi: 10.1111/andr.12970. Epub 2021 Feb 1.

COVID-19 and male reproduction: Current research and unknown factors

Yangcheng Yao  1 , Xiaoqiong Yuan  1 , Linjing Wu  1 , Na Guo  1 , Li Yin  1 , Yufeng Li  1
Affiliations
Review

COVID-19 and male reproduction: Current research and unknown factors

Yangcheng Yao et al. Andrology. 2021 Jul.

Abstract

Background: The testes are suspected target organs of SARS-CoV-2. However, the results of studies on the effect of COVID-19 on male reproduction are controversial.

Objective: To summarize current research on the effects of COVID-19 on male reproduction.

Methods: A systematic review of English literature was performed using PubMed and Ovid Embase up to 18 August 2020. Research articles on the presence of SARS-CoV-2 in semen, the effects of the virus on semen parameters and any pathological changes in the testes were evaluated.

Results: Fourteen studies were included in this review. Six of 176 survivors (3.4%) and 1 of 13 decedents (7.7%) in 2 of 12 studies were positive for viral RNA in semen and testicular tissue, respectively. After stratification of patient groups, we found that the virus was detected in the relatively early stage of infection, 6-16 days after disease onset, in semen from survivors. Two of 3 studies reported that some participants had substandard semen quality after COVID-19, and 1 study found that COVID-19 may impair semen quality in a severity-related manner. Pathological analyses showed that injuries to the seminiferous tubule occurred in all decedents (N = 11). Another study found that orchitic and testis fibrin microthrombi occurred in patients with fatal disease (100%, N = 2). Scrotal discomfort of orchiepididymitis or spermatic cord inflammation has also been reported in COVID-19 patients.

Conclusion: Current studies suggest that semen is rarely considered a carrier of SARS-CoV-2 genetic material during the infection period but not in the semen of recovered patients. Fatal COVID-19 may cause testicular structure damage without the presence of virus.

Keywords: COVID-19; SARS-CoV-2; male reproduction; semen; testis.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Flow chart of the study identification process.
See this image and copyright information in PMC

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