COVID-19 and Reproductive Function: A Detailed Review of Fertility Outcomes, Sperm Alterations, and Vertical Transmission Concerns: Impact of Covid-19 on male & female fertility

Wasi  Haider; Asfand Yar  Mujahid; Maryam  Sajjad; Arooj  Khan; Maria  Mumtaz; Ahmad  Imran; Ayesha  Anwar; Fatima  Aftab; Fahad  Amin; Syed Zeeshan Haider  Naqvi

doi:10.69750/dmls.01.07.063

Authors

Wasi Haider Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Asfand Yar Mujahid Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Maryam Sajjad Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Arooj Khan Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Maria Mumtaz Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Ahmad Imran Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Ayesha Anwar Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Fatima Aftab Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Fahad Amin Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author
Syed Zeeshan Haider Naqvi Institute of Molecular Biology and Biotechnology (IMBB),CRiMM, The University of Lahore, Lahore Pakistan. Author

DOI:

https://doi.org/10.69750/dmls.01.07.063

Keywords:

COVID-19, SARS-CoV-2, Reproductive Health, Fertility, Male Reproduction, Female Reproduction, Sperm Count, Vertical Transmission

Abstract

Background:The global COVID-19 pandemic, caused by SARS-CoV-2, raises concerns about its effects on reproductive health. Emerging evidence suggests potential impacts on male and female fertility, including hormonal changes, immune responses, and organ damage, though the virus’s direct influence on reproductive tissues and vertical transmission remains unclear.

Objective:This review summarizes current evidence on COVID-19’s effects on male and female reproductive health, focusing on sperm count, fertility, and vertical transmission.

Methods:A comprehensive literature review was conducted using databases such as PubMed, Scopus, and Web of Science. Peer-reviewed studies were included based on their relevance to reproductive outcomes, sperm count, hormonal changes, and vertical transmission of SARS-CoV-2.

Results:Most studies found no direct evidence of SARS-CoV-2 in male or female reproductive tissues. However, a temporary decline in sperm count and quality has been reported in men recovering from COVID-19. Hormonal fluctuations, particularly increased luteinizing hormone (LH) levels, were observed in some male patients. In females, the presence of ACE2 receptors in reproductive organs suggests a potential risk, but no conclusive evidence of impaired fertility has been found. Vertical transmission remains uncertain, with isolated cases reporting elevated IgM antibodies in newborns.

Conclusion:Although direct evidence of SARS-CoV-2 impacting fertility is limited, temporary reproductive disruptions in males, including reduced sperm count, have been noted. The risk of vertical transmission remains unclear. Further research is essential to determine COVID-19’s long-term reproductive effects.

Downloads

Download data is not yet available.

References

Tian Y, Zhou LQ. Evaluating the impact of COVID-19 on male reproduction. Reproduction. 2021;161(2):R37–44. doi:10.1530/REP-20-0523

He Y, Wang J, Ren J, Zhao Y, Chen J, Chen X. Effect of COVID-19 on male reproductive system: systematic review. Front Endocrinol. 2021;12:677701. doi:10.3389/fendo.2021.677701

Batiha O, Al-Deeb T, Al-Zoubi EA, Alsharu E. Impact of COVID-19 and other viruses on reproductive health. Andrologia. 2020;52(9):e13791. doi:10.1111/and.13791

Seymen CM. The other side of COVID-19 pandemic: effects on male fertility. J Med Virol. 2021;93(3):1396-402. doi:10.1002/jmv.26667

Khalili MA, Leisegang K, Majzoub A, Finelli R, Panner Selvam MK, Henkel R, et al. Male fertility and the COVID-19 pandemic. World J Mens Health. 2020;38(4):506-20. doi:10.5534/wjmh.200134

Chen F, Zhu S, Dai Z, Hao L, Luan C, Guo Q, et al. Effects of COVID-19 and mRNA vaccines on human fertility. Hum Reprod. 2021;37(1):5-13. doi:10.1093/humrep/deab238

Stanley KE, Thomas E, Leaver M, Wells D. COVID-19 and fertility: viral host-entry protein expression. Fertil Steril. 2020;114(1):33-43. doi:10.1016/j.fertnstert.2020.05.001

Tur-Kaspa I, Tur-Kaspa T, Hildebrand G, Cohen D. COVID-19 may affect male fertility but is not sexually transmitted. F&S Rev. 2021;2(2):140-9. doi:10.1016/j.xfnr.2021.01.002

Sansone A, Mollaioli D, Ciocca G, Limoncin E, Colonnello E, Vena W, et al. Male sexual & reproductive health in COVID-19. J Endocrinol Invest. 2021;44(2):223-31. doi:10.1007/s40618-020-01350-1

Madjunkov M, Dviri M, Librach C. COVID-19 impact on reproductive biology: Canadian perspective. J Ovarian Res. 2020;13(1):140. doi:10.1186/s13048-020-00737-1

Segars J, Katler Q, McQueen DB, Kotlyar A, Glenn T, Knight Z, et al. COVID-19 and human reproduction. Fertil Steril. 2020;113(6):1140-9. doi:10.1016/j.fertnstert.2020.04.025

Hajizadeh Maleki B, Tartibian B. COVID-19 and male reproductive function: cohort study. Reproduction. 2021;161(3):319-31. doi:10.1530/REP-20-0382

Jing Y, Run-Qian L, Hao-Ran W, Hao-Ran C, Ya-Bin L, Yang G, et al. COVID-19/ACE2 & female reproductive system. Mol Hum Reprod. 2020;26(6):367-73. doi:10.1093/molehr/gaaa030

Younis JS, Abassi Z, Skorecki K. ACE2 connection in male fertility during COVID-19. Am J Physiol Endocrinol Metab. 2020;318(6):E878-80. doi:10.1152/ajpendo.00183.2020

Ma L, Xie W, Li D, Shi L, Ye G, Mao Y, et al. Sex hormones & semen in COVID-19 men. J Med Virol. 2021;93(1):456-62. doi:10.1002/jmv.26259

Patel DP, Punjani N, Guo J, Alukal JP, Li PS, Hotaling JM. COVID-19 and male reproduction. Fertil Steril. 2021;115(4):813-23. doi:10.1016/j.fertnstert.2020.12.033

Yuksel B, Ozgor F. Female sexual behavior during COVID-19. Int J Gynaecol Obstet. 2020;150(1):98-102. doi:10.1002/ijgo.13193

Erbay G, Sanli A, Turel H, Yavuz U, Erdogan A, Karabakan M, et al. Short-term COVID-19 effects on semen. Andrology. 2021;9(4):1060-5. doi:10.1111/andr.13019

Phelan N, Behan LA, Owens L. COVID-19 and women's reproductive health. Front Endocrinol. 2021;12:642755. doi:10.3389/fendo.2021.642755

Gebhard C, Regitz-Zagrosek V, Neuhauser HK, Morgan R, Klein SL. Sex differences in COVID-19 outcomes. Biol Sex Differ. 2020;11(1):29. doi:10.1186/s13293-020-00304-9

Nassau DE, Best JC, Kresch E, Gonzalez DC, Khodamoradi K, Ramasamy R. SARS-CoV-2 & male reproductive health. BJU Int. 2022;129(2):143-50. doi:10.1111/bju.15573

Guo TH, Sang MY, Bai S, Ma H, Wan YY, Jiang XH, et al. Semen parameters in men recovered from COVID-19. Asian J Androl. 2021;23(5):479-83. doi:10.4103/aja.aja_31_21

Bowman CJ, Bouressam M, Campion SN, Cappon GD, Catlin NR, Cutler MW, et al. BNT162b2 vaccine & female fertility. Reprod Toxicol. 2021;103:28-35. doi:10.1016/j.reprotox.2021.05.007

Pradhan A, Olsson PE. Sex differences in COVID-19 severity. Biol Sex Differ. 2020;11(1):53. doi:10.1186/s13293-020-00330-7

Li G, Tang D, Song B, Wang C, Qunshan S, Xu C, et al. COVID-19 impact on sexual & reproductive health. J Med Internet Res. 2020;22(8):e20961. doi:10.2196/20961

Ding T, Wang T, Zhang J, Cui P, Chen Z, Zhou S, et al. Ovarian injury in COVID-19 women. Front Med. 2021;8:635255. doi:10.3389/fmed.2021.635255

Capuano A, Rossi F, Paolisso G. COVID-19 kills more men: reasons overview. Front Cardiovasc Med. 2020;7:131. doi:10.3389/fcvm.2020.00131

Fatima N, Fatima SN, Noor N, Khan M, Yahya K, Rizwan M, et al. COVID-19 antibodies in breast milk. Dev Med Life Sci. 2024;1(2):8-19. doi:10.69750/dmls.01.02.022

Riley T, Sully E, Ahmed Z, Biddlecom A. COVID-19 & reproductive health impact in LMICs. Int Perspect Sex Reprod Health. 2020;46:73-6. doi:10.1363/46e9020

Omolaoye TS, Adeniji AA, Cardona Maya WD, du Plessis SS. COVID-19 and male fertility. Reprod Toxicol. 2021;99:65-70. doi:10.1016/j.reprotox.2020.11.012

Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, et al. Sex hormones & menstruation in COVID-19 women. Reprod Biomed Online. 2021;42(1):260-7. doi:10.1016/j.rbmo.2020.09.020

Tang K, Gaoshan J, Ahonsi B, Ali M, Bonet M, Broutet N, et al. SRH during COVID-19. Reprod Health. 2020;17(1):59. doi:10.1186/s12978-020-0900-9

Song C, Wang Y, Li W, Hu B, Chen G, Xia P, et al. Absence of SARS-CoV-2 in semen/testes. Biol Reprod. 2020;103(1):4-6. doi:10.1093/biolre/ioaa050

Zupin L, Pascolo L, Zito G, Ricci G, Crovella S. SARS-CoV-2 & next-generation reproductive risks. J Assist Reprod Genet. 2020;37(10):2399-403. doi:10.1007/s10815-020-01917-0

Kadihasanoglu M, Aktas S, Yardimci E, Aral H, Kadioglu A. COVID-19 pneumonia & male hormones. J Sex Med. 2020;18(2):256-64. doi:10.1016/j.jsxm.2020.11.007

Masoudi M, Maasoumi R, Bragazzi NL. COVID-19 and sexual functioning: meta-analysis. BMC Public Health. 2022;22(1):189. doi:10.1186/s12889-021-12390-4

Temiz MZ, Dincer MM, Hacibey I, Yazar RO, Celik C, Kucuk SH, et al. SARS-CoV-2 in semen & male hormones. Andrologia. 2021;53(2):e13912. doi:10.1111/and.13912

Li H, Xiao X, Zhang J, Zafar MI, Wu C, Long Y, et al. Impaired spermatogenesis in COVID-19. eClinicalMedicine. 2020;28:100604. doi:10.1016/j.eclinm.2020.100604

Klein SL, Dhakal S, Ursin RL, Deshpande S, Sandberg K, Mauvais-Jarvis F. Biological sex impacts COVID-19 outcomes. PLoS Pathog. 2020;16(6):e1008570. doi:10.1371/journal.ppat.1008570