A recent study published in the journal Andrology has revealed that SARS-CoV-2, the virus responsible for COVID-19, may persist in sperm for several months after infection. This latest study builds on an expanding body of research on the subject and provides additional insight into the short and long-term effects of COVID-19 and male fertility.
COVID-19 and Male Fertility
Findings presented in 2023 showed how men infected with COVID-19 have decreased sperm counts and lower sperm motility for more than 3 months following even mild infections. This suggests that COVID does long-term damage to the male reproductive tract rather than a short term effect rectified with new sperm being produced.
More recently, researchers at the University of São Paulo in Brazil examined semen samples from 13 patients diagnosed with moderate to severe COVID-19 in the previous 30 to 90 days. While previous studies had shown that SARS-CoV-2 can invade the testicles, it had been challenging to detect the virus in semen using standard polymerase chain reaction (PCR) tests. Using more sensitive techniques, including transmission electron microscopy, researchers found that in nine of these patients, the virus was still present in their sperm up to 90 days after discharge from the hospital.
Electron microscopy (EM) revealed that sperm cells produce nuclear DNA-based extracellular traps, likely in response to the virus and similar to those seen in the body’s overall response to COVID-19. In moderate to severe cases, the blood-testis barrier, which normally protects the testes, may be less effective against different pathogenic viruses, including SARS-CoV-2. The virus could also enter the epididymis and bind to sperm cells. This could lead to the virus entering the sperm cell and potentially accomplishing a reverse transcription of the single-stranded viral RNA into proviral DNA. These processes can result in the release of cell-free DNA.
Potential Implications for Fertility
The presence of SARS-CoV-2 in sperm raises concerns about its impact on fertility. While further studies are needed to fully understand the consequences, there are several potential implications. The virus could affect sperm health and function, potentially leading to decreased fertility and a greater risk of miscarriage.
For those planning to have children, and given these findings, Jorge Hallak, professor at FM-USP and corresponding author of the study, suggests postponing natural conception for at least six months after infection by SARS-CoV-2, even in mild-covid cases. This applies all the more for assisted reproduction like IVF and ICSI.
Key Takeaway
It’s been four years since the first COVID-19 cases were recorded. It’s important to keep in mind that this is a relatively new area of research and more studies are needed to fully understand the long-term implications of the virus on male reproductive health. As our understanding of COVID-19 continues to evolve, it’s crucial to stay informed on the latest advice.
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