Impact of COVID-19 on Semen Quality among Males

This chapter aimed to assess the presence of SARC-CoV-2 in semen and its effect on semen quality, thereby providing insights into the early impact on male reproductive function. Viral infections have been a part of human existence to date, though viruses have posed a huge threat with various outbreaks lately. These threats are associated with reproductive health challenges, especially male infertility. Testicular tissue has abundant angiotensin-converting enzyme-2 receptors, which explains how coronavirus disease (COVID-19) can cause harm to multiple organ systems. However, little is known about how spermatogenesis and reproductive potential are affected by the shedding of SARS-CoV-2, or severe acute respiratory syndrome coronavirus-2, in semen.

A total of Thirty COVID-19 male patients aged 19-45 registered to AIIMS Patna hospital participated in the survey between October 2020 and April 2021. For every sample of semen, we performed a real-time reverse transcriptase assay. At the initial sampling, which took place during COVID-19, a thorough examination of the semen was performed, including the sperm DNA Fragmentation Index. We got the second sampling 74 days after the first sampling and carried out the aforementioned tests once again.

In our study, the semen parameters, such as sperm vitality and total motility, were decreased below the normal limits during the first sampling. In contrast, values of semen agglutination, sperm DFI, semen viscosity, and semen leukocytes were above their normal limits during the second sampling. All semen samples collected in the first and second sampling tested with real-time reverse transcription-polymerase chain reaction (RT-PCR) were negative for SARS-CoV-2. In the first sampling, semen volume, vitality, total motility, sperm concentration, total sperm count, % normal morphology, % cytoplasmic droplet, and fructose were significantly lower. Conversely, there was an increase in leukocytes, liquefaction time, semen viscosity, DNA Fragmentation Index, % head defect, and semen agglutination. At the second sampling, these results were reversed, though not to the best extent possible. Every single one of these results was statistically significant (p < 0.05). Thus, COVID-19 negatively affects semen parameters, including sperm DNA fragmentation index. One of the primary symptoms of COVID-19 is a high-grade fever, which may disrupt the blood-testis barrier, exposing the sperm cells and testicular tissues to circulating cytokines and other inflammatory mediators generated in the body. This may result in a systemic inflammatory state and immune response against the seminiferous epithelium and accessory glands resulting in low semen quality. This study suggests that assisted reproductive technology (ART) clinics and sperm banking facilities should consider assessing detailed semen analysis of males with a history of COVID-19.