Semen parameters and male reproductive potential are not adversely affected after three or more months of recovery from COVID-19 disease

Sara Stigliani; Claudia Massarotti; Francesca Bovis; Elena Maccarini; Paola Anserini; Paola Scaruffi

doi:10.3389/frph.2022.1114308

Semen parameters and male reproductive potential are not adversely affected after three or more months of recovery from COVID-19 disease

Front Reprod Health. 2023 Jan 20:4:1114308. doi: 10.3389/frph.2022.1114308. eCollection 2022.

Authors

Sara Stigliani¹, Claudia Massarotti^{1

2}, Francesca Bovis³, Elena Maccarini¹, Paola Anserini¹, Paola Scaruffi¹

Affiliations

¹ UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
² Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Health (DiNOGMI), University of Genova, Genova, Italy.
³ Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.

Abstract

Background: The male reproductive system may be a potential target for SARS-CoV-2 since the presence of ACE and TMPRS2 receptors. After a first report of the presence of SARS-CoV-2 in semen of COVID-19 patients, several papers reported that SARS-CoV-2 was not detected in the semen. However, some evidences indicated that COVID-19 disease could impair semen parameters. During the infection, or in a short period after, a reduction in sperm concentration and motility and an increase in DNA fragmentation were observed, even in asymptomatic patients. There is no conclusive data exploring whether this damage changes with time. We investigated whether COVID-19 disease has a negative impact on semen parameters and male reproductive potential after recovery.

Methods: In this longitudinal retrospective study, we enrolled 20 men who had COVID-19 disease. We compared sperm parameters in samples collected before COVID-19 and after infection (8.3 ± 4.8 months). We also evaluated the reproductive potential in pre- and post-COVID-19 infertility treatments of 8 self-controlled couples as well as in 40 cycles after COVID-19 infection of the male partner.

Results: For most patients, we obtained results of more than one semen analysis before and after COVID-19. After adjusting for age, days of sexual abstinence, frequency of ejaculations and presence of fever, we found no significant difference over time in any semen parameter. The interval between COVID-19 infection and subsequent infertility treatments was 10.7 ± 7.5 months. There were no differences in the embryological and clinical outcomes of infertility treatments performed before and after male infection. One couple obtained a single pregnancy in the post COVID-19 IUI. Normal fertilization (65%), cleavage (99%) and blastocyst development (40%) rates in treatments performed after male infection were within the expected range of competencies. A total of 5 singleton and 1 twin clinical pregnancies were obtained, and 6 healthy children were born. A total of 10 blastocysts have been cryopreserved.

Conclusion: Our data are reassuring that COVID-19 disease has no negative effect on semen quality and male reproductive potential when semen samples are collected three months or more after infection.

Keywords: COVID-19; IVF; male fertility; male reproduction; semen analysis.