Effect of COVID-19 infection on characteristics of sperm in men with impaired fertility
Authors: Sorokina T. M. , Bragina E. E. , Sorokina E. A. , Sedova A. O. , Shtaut M. I. , Kurilo L. F. , Chernykh V. B. 
Published: September 2021

Introduction. The risk of infection with SARS-CoV-2 virus and potential cross-infection in an in vitro fertilization laboratory remains unclear. SARS-CoV-2 enters the body through angiotensin-converting enzyme 2 receptor. There is a possibility that high expression of angiotensin-converting enzyme 2 on testicular cells can lead to spermatogenesis disfunction and decreased quality of the ejaculate.

The study objective is to compare quantitative and qualitative sperm characteristics in patients who sought medical help at the Laboratory of Genetics of Reproductive Disorders at the Research Centre for Medical Genetics with reproduction problems between 2017 and 2020 with a focus on the period of COVID-19 pandemic.

Materials and methods. Results of semen analysis of 4403 patients (mean age 34 years) were considered. Taking into account histories of patients examined in 2020, a separate group of 428 men was formed with 42 men with a history of coronavirus infection confirmed by lab tests (40 cases of mild disease, 2 cases of moderate disease). In 14 patients, sperm analysis was performed twice: prior to COVID-19 and after. Standard sperm analysis was performed in accordance with the World Health Organization Guidelines. For statistical analysis Student’s t-test was used with significance level p <0.05.

Results. Results of 2020 semen analyses were compared to the control group including 3300 patients examined between 2017 and 2019 prior to emergence of COVID-19 virus in Russia. Decreased mean sperm count was observed in patients examined in 2020 compared to the control group: 302 ± 6 million versus 250 ± 8 million with concurrent increased sperm motility (14.7 ± 0.2 % versus 16.5 ± 0.4 %) and improved sperm morphological (3.07 ± 0.05 % versus 3.92 ± 0.11 %). The differences for these three sperm parametres are statistically significant. In 2020, normospermia was observed in 10.3 % of cases which does not significantly differ from 2017 and 2019 levels. Comparison of semen analyses in 2020 showed that the percentage of normospermia in patients after COVID-19 infection was almost 2-fold lower than in the control group of patients without history of the infection (7.1 % vs 13 %) and percentage of azpoospermia was more 2.5-fold higher (7.1 % vs 2.5 %). In 14 patients, sperm analyses before and after COVID-19 were compared. Mean sperm count after the disease decreased from 244 ± 74 million to 178 ± 34 million. Mean motility characteristics (12.7 and 15.8 %) and normal sperm morphology (2.6 and 3.2 %), on the other hand, had an upward trend after the disease. However, these differences were not statistically significant.

Conclusion. In conclusion, SARS-CoV-2 virus and condition of COVID-19 pandemic did not lead to serious decrease in sperm quality in the studied group of Russian patients in 2020. This can be associated with small number of patients after the infection included in the sample, as well as general trend toward improvement in sperm quality observed in recent years.