The pandemic has had an effect on almost everything and everybody. Research is still ongoing to see whether sperm quality can be damaged when the person has been diagnosed as Covid positive. The disease causes respiratory illness, through droplets targeting the lungs, kidneys, intestines and heart. The same cells that the virus attacks in the lung tissue are also present in the testicles.
Hence, it is possible that male reproductive organs can be infected which may cause an increase in sperm cell death, impairment of sperm cell development, disruption of male reproductive hormones, inflammation of the testicles and oxidative stress. All of these can reduce male fertility.
Research has shown that men with Covid 19 had higher levels of the ACE2 enzyme, which helps the virus enter the testicular cells. ACE2 (Angiotensin-converting enzyme) is a protein on the surface of many types of cells, including the male reproductive cells. One of the functions of ACE2 includes regulating testosterone production.
Also, higher levels of both pro and anti inflammatory cytokines (molecules that mediate and regulate immunity and inflammation) were noticed in the sperm. Inflammation and oxidative stress in sperm cells were increased by more than 100% in Covid patients. Oxidative stress (OS) is the result of an imbalance between antioxidants and the reactive oxygen species (ROS) in the body, which can cause damage to the sperm.
The studies also showed higher levels of ROS (reactive oxygen species). Low levels of ROS are essential for fertility but excessive levels can kill the response of immune cells to spread of microbes. The tests also noted lower levels of SOD (superoxide dismutases). This is an enzyme that helps break down harmful oxygen molecules and which defends the cells against ROS, preventing damage to tissues.
Sperm concentration was drastically reduced and so was the sperm cell shape. Change in apoptosis (the death of cells as a normal part of an organism’s development) was also noticed.
However, these conditions can improve with time and may cause just a transient state of male infertility. Also, the magnitude of these conditions was dependent on the severity of the disease. In addition, the patients on whom research was done differed in age, weight and fat percentage, which could have had an effect on the results.
Another point to take into consideration. Covid patients are treated with corticosteroids and antiviral therapies, so this could also have had a damaging effect on the sperm results.
According to the researcher, Hajizadeh Malekiand Tartibian, “Female partners of men recovering from the disease should decide not to conceive until a specialist carefully examines and certifies their fertility status”.
Even though there is no 100% proof that Covid patients can suffer damage (permanent or transient) to sperm quality and no conclusive evidence of male infertility, it is worth taking the above facts into consideration. After recovery from the disease, a semen analysis can be conducted to verify the sperm quality.