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
DOI:
https://doi.org/10.69750/dmls.01.07.063Keywords:
COVID-19, SARS-CoV-2, Reproductive Health, Fertility, Male Reproduction, Female Reproduction, Sperm Count, Vertical TransmissionAbstract
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.
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References
Tian Y, Zhou L-q. Evaluating the impact of COVID-19 on male reproduction. Reproduction. 2021;161(2): R37-R44.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 – A Systematic Review. Frontiers in Endocrinology. 2021; 12.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. Journal of Medical Virology. 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: Systematic Review of the Literature. World J Mens Health. 2020;38(4):506-20.doi: 10.553 4/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. Human Reproduction. 2021;37(1):5-13.doi: 10.1093/ humrep/deab238
Stanley KE, Thomas E, Leaver M, Wells D. Coronavirus disease-19 and fertility: viral host entry protein expression in male and female reproductive tissues. Fertility and Sterility. 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: a systematic review. F&S Reviews. 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. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak. Journal of Endocrinological Investigation. 2021;44(2):223-31.doi: 10.1007/s40618-020-01350-1
Madjunkov M, Dviri M, Librach C. A comprehensive review of the impact of COVID-19 on human reproductive biology, assisted reproduction care and pregnancy: a Canadian perspective. Journal of Ovarian Research. 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. Prior and novel coronaviruses, Coronavirus Disease 2019 (COVID-19), and human reproduction: what is known? Fertility and Sterility. 2020;113(6): 1140-9.doi: 10.1016/j.fertnstert.2020.04.025
Hajizadeh Maleki B, Tartibian B. COVID-19 and male reproductive function: a prospective, longitudinal 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. Potential influence of COVID-19/ACE2 on the female reproductive system. Molecular Human Reproduction. 2020;26(6):367-73.doi: 10.1093/molehr/gaaa030
Younis JS, Abassi Z, Skorecki K. Is there an impact of the COVID-19 pandemic on male fertility? The ACE2 connection. American Journal of Physiology-Endocrinology and Metabolism. 2020;318(6):E878-E80.doi: 10.1152/ajpendo.00183.2020
Ma L, Xie W, Li D, Shi L, Ye G, Mao Y, et al. Evaluation of sex-related hormones and semen characteristics in reproductive-aged male COVID-19 patients. Journal of Medical Virology. 2021;93(1):456-62.doi: https://doi.org/10.1002/jmv.26259
Patel DP, Punjani N, Guo J, Alukal JP, Li PS, Hotaling JM. The impact of SARS-CoV-2 and COVID-19 on male reproduction and men’s health. Fertility and Sterility. 2021;115(4):813-23.doi: https://doi.org/10.1016/j.fertnstert.2020.12.033
Yuksel B, Ozgor F. Effect of the COVID-19 pandemic on female sexual behavior. International Journal of Gynecology & Obstetrics. 2020;150(1):98-102.doi: https://doi.org/10.1002/ijgo.13193
Erbay G, Sanli A, Turel H, Yavuz U, Erdogan A, Karabakan M, et al. Short-term effects of COVID-19 on semen parameters: A multicenter study of 69 cases. Andrology. 2021;9(4):1060-5.doi: https://doi.org/10.1111/andr.13019
Phelan N, Behan LA, Owens L. The Impact of the COVID-19 Pandemic on Women’s Reproductive Health. Frontiers in Endocrinology. 2021;12.doi: 10.3389/fendo.2021.642755
Gebhard C, Regitz-Zagrosek V, Neuhauser HK, Morgan R, Klein SL. Impact of sex and gender on COVID-19 outcomes in Europe. Biology of Sex Differences. 2020;11(1):29.doi: 10.1186/s13293-020-00304-9
Nassau DE, Best JC, Kresch E, Gonzalez DC, Khodamoradi K, Ramasamy R. Impact of the SARS-CoV-2 virus on male reproductive health. BJU International. 2022;129(2):143-50.doi: https://doi.org/10.1111/bju.15573
Guo T-H, Sang M-Y, Bai S, Ma H, Wan Y-Y, Jiang X-H, et al. Semen parameters in men recovered from COVID-19. Asian Journal of Andrology. 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. Lack of effects on female fertility and prenatal and postnatal offspring development in rats with BNT162b2, a mRNA-based COVID-19 vaccine. Reproductive Toxicology. 2021;103:28-35.doi: https://doi.org/10.1016/j.reprotox.2021.05.007
Pradhan A, Olsson P-E. Sex differences in severity and mortality from COVID-19: are males more vulnerable? Biology of Sex Differences. 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. Impact of the COVID-19 Pandemic on Partner Relationships and Sexual and Reproductive Health: Cross-Sectional, Online Survey Study. 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. Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study. Frontiers in Medicine. 2021;8.doi: 10.3389/fmed.2021.635255
Capuano A, Rossi F, Paolisso G. Covid-19 Kills More Men Than Women: An Overview of Possible Reasons. Frontiers in Cardiovascular Medicine. 2020;7.doi: 10.3389/fcvm.2020.00131
Fatima N, Fatima SN, Noor N, Khan M, Yahya K, Rizwan M, et al. Persistence and Efficacy of Maternal COVID-19 Vaccine-Induced Antibodies in Human Milk: A Comprehensive Meta-Analysis: Analyzing the Durability and Impact of COVID-19 Vaccine Antibodies in Breast Milk. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(2):8-19.doi: 10.69750/dmls.01.02.022
Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health In Low- and Middle-Income Countries. International Perspectives on Sexual and Reproductive Health. 2020;46:73-6.doi: 10.1363/46e9020
Omolaoye TS, Adeniji AA, Cardona Maya WD, du Plessis SS. SARS-COV-2 (Covid-19) and male fertility: Where are we? Reproductive Toxicology. 2021;99:65-70.doi: https://doi.org/10.1016/j.reprotox.2020.11.012
Li K, Chen G, Hou H, Liao Q, Chen J, Bai H, et al. Analysis of sex hormones and menstruation in COVID-19 women of child-bearing age. Reproductive BioMedicine Online. 2021;42(1):260-7.doi: https://doi.org/10.1016/j.rbmo.2020.09.020
Tang K, Gaoshan J, Ahonsi B, Ali M, Bonet M, Broutet N, et al. Sexual and reproductive health (SRH): a key issue in the emergency response to the coronavirus disease (COVID- 19) outbreak. Reproductive 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 2019 novel coronavirus in semen and testes of COVID-19 patients†. Biology of Reproduction. 2020;103(1):4-6.doi: 10.1093/biolre/ioaa050
Zupin L, Pascolo L, Zito G, Ricci G, Crovella S. SARS-CoV-2 and the next generations: which impact on reproductive tissues? Journal of Assisted Reproduction and Genetics. 2020;37(10):2399-403.doi: 10.1007/s10815-020-01917-0
Kadihasanoglu M, Aktas S, Yardimci E, Aral H, Kadioglu A. SARS-CoV-2 Pneumonia Affects Male Reproductive Hormone Levels: A Prospective, Cohort Study. The Journal of Sexual Medicine. 2020;18(2):256-64.doi: 10.1016/j.jsxm.2020.11.007
Masoudi M, Maasoumi R, Bragazzi NL. Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and 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. Investigation of SARS-CoV-2 in semen samples and the effects of COVID-19 on male sexual health by using semen analysis and serum male hormone profile: A cross-sectional, pilot study. Andrologia. 2021;53(2):e13912.doi: https://doi.org/10.1111/and.13912
Li H, Xiao X, Zhang J, Zafar MI, Wu C, Long Y, et al. Impaired spermatogenesis in COVID-19 patients. eClinicalMedicine. 2020;28.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 Pathogens. 2020;16(6):e1008570.doi: 10.1371/journal.ppat.1008570
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