The chief reproductive specialist of Russia spoke about infertility due to COVID-19

Scientists from different countries have asked the question: does COVID-19 infection affect the fertility of the stronger sex? Opinions were divided, which is not surprising. Too little time has passed since the beginning of the pandemic to draw global conclusions about the ability of the male body to conceive offspring after suffering a coronavirus.

Male response to coronavirus

And yet – how real is the prospect of becoming infertile among the stronger sex who have had COVID-19? To answer this question, we asked the chief specialist in reproductive health of the Ministry of Health of Russia, director of the N.V. Lopatkina (branch of the National Medical Research Center of Radiology of the Ministry of Health of the Russian Federation), Professor Oleg APOLIKHIN.

“The pandemic is already dictating many reproductive restrictions,” Oleg Ivanovich said in an interview with MK. – The spread of SARS-CoV-2 has led to the shutdown of most assisted reproductive technology clinics. In addition, international communities have recommended that potential parents, patients and donors avoid participating in reproduction and pregnancy programs during a pandemic.

And if we talk about the possible impact (COVID-19) on the male reproductive system, then in March of this year, information about this appeared in international publications. In particular, it was indicated that the new coronavirus (SARS-CoV-2) can cause male infertility by analogy with the Middle East respiratory syndrome virus (MERS-CoV) and severe acute respiratory syndrome virus (SARS-CoV), for which a similar effect was previously recorded …

The penetration of the virus into the blood is considered one of the main causes of positive semen samples. And the hemato-testicular barrier (HTB), which prevents the penetration of cytotoxins from the blood into the seminiferous tubules, is an imperfect barrier to the penetration of infection, especially in the presence of systemic or local inflammation. More than 27 viruses of various families are known that can enter the bloodstream during the acute period of an infectious viral disease. And at least 11 of them are found in the testes.

In this case, some viruses multiply in the male reproductive tract, others can persist for years in cells or secretions in the form of free particles. It should also be borne in mind that not all drugs overcome this barrier, which I mentioned above, and viruses can persist in semen, despite systemic natural cleansing in the body.

Scientists from the Faculty of Medicine at the Italian University (Padua) also do not deny the possible negative impact of the new coronavirus on testicular tissue. Moreover, it is believed that autoimmune damage can cause male infertility in the medium and long term in men who have had COVID-19, even in a mild or asymptomatic form.

And before that, Chinese researchers found that in some cases, SARS-CoV-2 penetrates the testicles and infects sperm, thereby increasing the risk of infertility in men. Thus, the new virus infects not only the lungs, intestines, spleen, kidneys and lymph nodes – it also targets the human reproductive organs.

But … The data available in the world literature on the presence of viral particles of the new coronavirus (SARS-CoV-2) in the ejaculate (in the seminal fluid of men) or other discharge of the male reproductive system are very contradictory.

So, given the high pathogenicity of the new coronavirus infection and the likely long-term negative consequences for the male reproductive potential, it is extremely important to conduct research in this direction in Russia as well.

If the hypothesis of the effect of testosterone on the course of COVID-19 is confirmed in large studies, then men may be recommended to normalize testosterone levels in combination with standard therapy. In addition, men of reproductive age who have had COVID-19 may need to stimulate spermatogenesis.

Of course, during a pandemic, saving lives is a top priority for healthcare. But the study of the effect of this virus on male fertility cannot be postponed indefinitely. It should be studied in recovered patients.

And men themselves, after suffering a new covid infection, do not need to take care of their reproductive health. To begin with, at least take a blood test for hormones and do a laboratory study of sperm (spermogram). And make sure that everything is in order with the reproductive system.