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In the initial days of the COVID-19 pandemic, there were reports of the viral disease impacting men differently. Some expert also spoke about the effect of the virus on male fertility and sperm quality. But soon, in the face of unprecedented calamity in the form of a worldwide lockdown and severe economic hardships, this matter was relegated to the background. But research on the subject continued and now a new study from the Justus Liebig University Giessen, in Hesse, Germany, says that severe cases of COVID-19 might impact the quality of a man's sperm, thus possibly impacting his fertility. This was published on Thursday in the journal Reproduction.
Researchers say that this report provides the first direct evidence till date that COVID-19 infection impairs semen quality and male reproductive potential. But some experts not involved in the said study are sceptical about the findings and have raised doubts about the report's conclusion. They also urged caution in overgeneralizing the research findings.
Compared to healthy men without COVID-19, the study found a significant increase in inflammation in sperm cells in men with COVID-19. Experts urged caution about the report's conclusions. One expert from another university has a problem with the interpretation of data in this study. For example, the authors state that their data demonstrates that 'COVID-19 infection causes significant impairments of male reproductive function'. Yet, it only actually shows an association.
For the purpose of the study, researchers matched 105 fertile men without COVID-19 to 84 fertile men diagnosed with the coronavirus and analyzed their semen at 10-day intervals for 60 days. Compared to healthy men without COVID-19, the study found a significant increase in inflammation and oxidative stress in sperm cells belonging to men with COVID-19. Their sperm concentration, mobility and shape were also negatively impacted by the virus. The differences grew with the severity of the sickness, the study found.
These effects on sperm cells are associated with lower sperm quality and reduced fertility potential. Although these effects tended to improve over time, they remained significantly and abnormally higher in the COVID-19 patients, and the magnitude of these changes were also related to disease severity. There were also much higher levels of ACE2 enzymatic activity in men with COVID-19, the study found. ACE2, or angiotensin-converting enzyme 2, is the protein that provides the entry point for the novel coronavirus to hook into and infect a wide range of human cells. It is not really surprising that COVID-19 may impact the male reproductive system because ACE2 receptors, or the "same" receptors which the virus uses to gain access to the tissues of the lung, are also found in the testicles.
It is a fact of life that any illness can temporarily bring down the sperm count (sometimes to zero) for a few weeks or months. Hence, argue some experts, this makes it difficult to work out how much of the reductions observed in this study were specific to COVID-19 rather than just from being ill. Moreover, researchers found no evidence of the COVID-19 virus in the semen of infected men and there is no evidence that this virus can be transmitted via semen. Most men diagnosed with COVID-19 are obese and we know that obesity reduces sperm quality. The COVID treatments may also affect these men's sperm quality, rather that COVID-19 itself. Thus, more studies are needed before the testes is considered to be a high-risk organ specific to COVID-19.
(With inputs from Agencies)
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