Ces Urol 2022, 26(4):224-231 | DOI: 10.48095/cccu2022030

The effect of covid-19 on male fertility

Silvie Ostřížková¹, Renata Zlotkowska^{1, 2}

¹ Ústav epidemiologie a ochrany veřejného zdraví, Ostravská univerzita, Ostrava, Česká republika

² Centrum pracovního lékařství Malopolského vojvodství v Krakově, Krakov, Polsko

Ostřížková S, Zlotkowska R. The effect of covid-19 on male fertility. Covid-19 disease has spread rapidly across continents since 2019, causing a pandemic. A higher prevalence of the disease has been observed in males, partly due to higher expression of angiotensin-converting enzyme 2 (ACE2), which, together with transmembrane serine protease 2 (TMPRSS2), plays an important role in viral entry into the cell. Both ACE2 and TMPRSS2 are expressed on the surface of many human tissues, including tissues of the male and female reproductive system. For this reason, the effect of SARS-CoV-2 on male fertility is still under investigation. Current studies have focused on histopathological changes in post mortem testicular samples from covid-19 positive patients, but also on immune responses induced by SARS-CoV-2. Cytokine storm caused by cell pyroptosis and oxidative stress may have a negative impact. As most viruses, including SARS-CoV-2, are able to break the bloodbrain barrier, the hypothalamic-pituitary-gonadal axis, essential for endocrine regulation of spermatogenesis, may also be affected. Patients with covid-19 disease show higher levels of luteinizing hormone and prolactin and lower levels of testosterone due to Leydig cell damage. Sperm analysis showed a deterioration of total sperm motility and a decrease in sperm concentration in the ejaculate. However, the effect on spermiogram parameters appears to be temporary.

Keywords: ACE2, coronavirus, covid-19, male fertility.

Received: September 7, 2022; Revised: October 19, 2022; Accepted: October 19, 2022; Prepublished online: October 25, 2022; Published: December 8, 2022