key: cord-0819736-295li6pq
authors: Sadeghi, Mohammad Reza
title: Is Male Reproductive System More Vulnerable to SARS-CoV-2 Than Female’s?
date: 2021
journal: J Reprod Infertil
DOI: 10.18502/jri.v22i1.4989
sha: f2f67315dff19dec0fdf35039d0993c7f22a08b7
doc_id: 819736
cord_uid: 295li6pq

nan

Immunohistochemical examination on slides of testicular tissue of dead men from COVID-19 showed orchitis-like syndrome with a large amount of IgG deposition in the seminiferous epithelium and also destroyed spermatogenic and Sertoli cells. This may be a key factor for secondary autoimmune response to SARS-CoV-2 virus, thereby leading to exacerbation of testicular damage with autoimmune orchitis (1). SARS-CoV-2 may directly affect the hypothalamic-pituitary-gonadal axis and subsequently impair Leydig cells' functions, testosterone production, and significantly increase serum LH and prolactin. Based on the available data, cells of the nervous system extensively express ACE2 receptors, which may be a possible explanation for the neurological symptoms of COVID-19 and consequent SARS-CoV-2 damage on the hypothalamic-pituitary-testis axis. Thus, the production of pituitary and testicular hormones and male fertility are affected. In addition, elevated ROS production, oxidative stress and sperm DNA fragmentation due to longterm fever are another mechanism for destruction of male fertility by SARS- CoV-2 virus (3, 4) .

The SARS-CoV-2 pandemic has raised concerns about male fertility over the past 10 months, and a comprehensive review of studies with controversial evidence necessitates more investigations on the relationship between COVID-19 and fertility. Despite the lack of conclusive findings for preventing its effects on the reproductive system, this is a starting point for further research into the effects of COVID-19 disease on male fertility. There has always been concern about a gradual decline in sperm quantity and quality and thus male fertility over time, with some studies reporting a 50% reduction in semen quality over less than half a century. Though the causative factors have not been identified yet, lifestyle and environmental factors seem to be the fundamental influences. Due to above clinical features of COVID-19, the SARS-CoV-2 may also exacerbate this process; therefore, assessing the effects of the virus on spermatogenesis and male fertility is an exigency which requires serious attention and further studies in future.

Coronavirus: a possible cause of reduced male fertility. Andrology

Male fertility and the COVID-19 pandemic: systematic review of the literature

Does SARS-CoV-2 have influence on male reproductive system?

Coronavirus disease-19 infection: implications on male fertility and reproduction

Impaired spermatogenesis in COVID-19 patients