Impact of SARS-CoV-2 on the Male Reproductive Tract: Insights from Semen
Analysis and Cryopreservation
Abstract
SARS-CoV-2, the virus behind the COVID-19 pandemic, affects multiple
organs, including the male reproductive system. The male reproductive
tract expresses ACE-2, the primary viral entry receptor, in
spermatogonia, Leydig, and Sertoli cells. While viral infections can
harm male fertility through cytokine storms, the effects of SARS-CoV-2
on fertility are still unclear. Thus, this study aimed to examine the
impact of COVID-19 on the male reproductive tract. Semen samples from 20
patients, collected 3 months post-SARS-CoV-2 infection, revealed the
presence of ACE2 and TMPRSS2 receptors in both plasmatic and spermatozoa
fractions. Five patients showed viral RNA-dependent RNA polymerase
(RdRp), indicating potential viral persistence. Elevated levels of
inflammatory cytokines and chemokines were observed in the plasmatic
fraction, suggesting a persistent inflammatory condition affecting sperm
vitality. Immune cell populations associated with viral clearance were
identified in the semen fraction, correlating with receptor expression
and inflammatory cytokines. To address SARS-CoV-2 uncertainties in
reproductive medicine, we assessed the virus’s presence in seminal fluid
before and after cryopreservation using slow freezing and vitrification.
Our study confirms the safety of both techniques in preserving male
fertility for assisted reproductive technology programs. In conclusion,
our study highlights the impact of SARS-CoV-2 on male reproductive
health, emphasizing the persistence of viral entry receptors, potential
viral RNA presence, the inflammatory environment, and the involvement of
immune populations in the male reproductive tract post-infection.
Importantly, we confirm the safety of conventional freezing and
vitrification techniques for preserving male fertility in assisted
reproductive technology programs amidst the COVID-19 pandemic.