Mid- and Long-Term Impact of COVID-19 on Male Fertility

Evaluation of Mid- and Long-Term Impact of COVID-19 on Male Fertility Through Evaluating Semen Parameters

Bintao Hu; Kang Liu; Yajun Ruan; Xian Wei; Yue Wu; Huan Feng; Zhiyao Deng; Jihong Liu; Tao Wang

Transl Androl Urol. 2022;11(2):159-167.

Abstract and Introduction

Abstract

Background: The coronavirus disease 2019 (COVID-19) has spread worldwide with alarming levels of spread and severity. The distribution of angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) from bioinformatics evidence, the autopsy report for COVID-19 and the published study on sperm quality indicated COVID-19 could have a negative impact on male fertility. However, whether the negative impact of COVID-19 on male fertility is persistent remains unknown, which requires long-term follow-up investigation.

Methods: Semen samples were collected from 36 male COVID-19 patients with a median recovery time of 177.5 days and 45 control subjects. Then, analysis of sperm quality and alterations of total sperm number with recovery time were performed.

Results:There was no significant difference in semen parameters between male recovered patients and control subjects. And the comparisons of semen parameters between first follow-up and second follow-up revealed no significant difference. In addition, we explored the alterations of sperm count with recovery time. It showed that the group with recovery time of ≥120 and <150 days had a significantly lower total sperm number than controls while the other two groups with recovery time of ≥150 days displayed no significance with controls, and total sperm number showed a significant decline after a recovery time of 90 days and an improving trend after a recovery time of about 150 days.

Abstract and Introduction
Methods
Results
Discussion
Conclusions
References

Table 1. Demographics, clinical characteristics of recovered COVID-19 patients and controls
Characteristic	Recovered COVID-19 patients	Age-matched healthy controls
Individuals, n	36	45
Age, years	31.75±5.77	31.49±3.10
Smoker, n	5/36	–
Drinker, n	8/36	–
Pharyngeal swab positive, n	36/36	0/45
Symptoms, n
Fever	30/36	0/45
Cough	3/36	–
Diarrhea	7/36	–
Classification of illness, n
Mild	4/36	–
Moderate	17/36	–
Severe	15/36	–
Past history, n
Mumps	0/36	0/45
Varicocele	2/36	0/45
Recovery time, days	177.5 (150.8–187.0)	–

Data presented as mean ± standard deviation, unless specified otherwise. COVID-19, coronavirus disease 2019; n, number.

Table 2. Comparisons of semen parameters between recovered patients and controls
Semen parameters	Age-matched healthy controls (n=45)	Recovered COVID-19 patients (n=36)	P
Age, years	31.49±3.10	31.75±5.77	0.808
Recovery time, days	–	177.5 (150.8–187.0)	–
Abstinence, days	4.00 (3.00–6.50)	4.00 (3.00–5.00)	0.137
PH	7.20 (7.20–7.50)	7.20 (7.20–7.50)	0.554
Volume, mL	3.27±0.92	2.86±1.19	0.096
Concentration, ×10⁶/mL	59.28 (44.92–77.47)	56.55 (40.15–88.84)	0.732
Total number, ×10⁶	178.52 (130.64–303.70)	158.50 (77.86–214.63)	0.165
Progressive motility, %	46.19 (37.21–50.82)	40.43 (32.87–50.16)	0.170
Total motility, %	56.58 (47.44–59.57)	48.12 (39.17–60.02)	0.337

Data presented as mean ± standard deviation or median (interquartile range). COVID-19, coronavirus disease 2019; PH, hydrogen ion concentration; n, number; P refers to the statistical significance of difference in semen parameters between age-matched healthy controls and recovered COVID-19 patients.

Table 3. Comparisons of semen parameters between first and second follow-up (n=31)
Semen parameters	First follow-up	Second follow-up	P
Recovered time, days	83.00 (64.00–94.00)	175.00 (150.00–184.00)	NA
Abstinence, days	4.29±1.49	4.19±1.14	0.777
PH	7.38±0.18	7.34±0.22	0.425
Volume, mL	2.90 (1.80–3.50)	3.00 (1.90–3.80)	0.590
Total number, ×10⁶	182.29±107.98	181.48±137.00	0.972
Concentration, ×10⁶/mL	67.07±34.45	60.65±26.96	0.171
Total motility, %	50.91±12.76	48.90±13.88	0.427
Progressive motility, %	42.98±11.82	40.20±12.33	0.200

Data presented as mean ± standard deviation or median (interquartile range). PH, hydrogen ion concentration; n, number; NA, not available; P refers to the statistical significance of difference in semen parameters between first follow-up and second follow-up.