3 ; 1 ; in Month : January (2021) Article No : sphrj-v3-1013
Nasser Mikhail, Soma Wali

Abstract
Background: The impact of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-Cov-2) on male fertility is unclear. Objective: To clarify the effects of COVID-19 on male gonadal function. Methods: PubMed search up to March 4, 2021. Search terms included COVID-19, testicles, testosterone, spermatogenesis, hypogonadism. Case reports, retrospective, prospective, cross-sectional and autopsy studies are included. Results: Orchitis and/or epididymitis were demonstrated by scrotal ultrasound (US) in approximately 22-42% of men with COVID-19 admitted to the hospital and can be frequently asymptomatic. Circulating testosterone levels are reduced in men admitted with severe COVID-19 with concomitant elevation of luteinizing hormone (LH) consistent with testicular dysfunction. Men recovering from severe COVID-19 exhibit abnormal semen parameters. Few studies detected SARS-CoV-2 in semen during active COVID-19 infection and after recovery. Autopsy investigations showed extensive damage of testicular tissues and evidence of inflammation and presence of SARS-CoV-2 in testicles of men who died from severe COVID-19. Conclusion: COVID-19, particularly in its severe presentation, may compromise male gonadal function and fertility. Evaluation of semen analysis after recovery from COVID-19 is necessary to rule out any residual effects on sperm quality.

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