P-051 Reduced sperm count in Indian men post recovery from SARS-CoV-2 (COVID-19) infection: a worrying trend
Authors: Mittal G , Mantravadi K.C , Gedela D.R 
Published: June 2022

Abstract

Study question
To investigate whether sperm count was affected in COVID-19 infected men post-recovery.

Summary answer
Reduced sperm counts were detected in individuals who had recovered post-COVID-19 infection.

What is known already
Coronavirus disease (COVID-19) that led to the ongoing global pandemic has been predominantly linked with respiratory tract illness, but it posed serious healthcare challenges across medical fields including fertility medicine. The possibility of testicular cells being a potential target site for the SARS-CoV-2 virus was recently hypothesised and hence here we assess the ramifications of COVID-19 on the semen parameters in men post-recovery.

Study design, size, duration
20 individuals were recruited for this multicenter cross-sectional study conducted between January 2021 to November 2021. Registered male patients from our database who had tested positive for COVID-19 were contacted and were invited for two semen analyses 74 days apart after they had fully recovered. All the selected participants were between the ages of 25 and 35, sexually active and were being treated for unexplained infertility.

Participants/materials, setting, methods
We subjected all the selected individuals to semen analysis according to the WHO Manual for Semen Analysis before they tested positive for COVID-19.
After testing positive for COVID-19 on a nasopharyngeal SARS-CoV-2 real-time polymerase chain reaction swab test (RT-PCR), these individuals were subjected to two semen analyses, performed 74 days apart after they had fully recovered from COVID-19. Their pre and post COVID-19 sperm counts were compared and statistically analysed.

Main results and the role of chance
The average duration of a spermatogenic cycle in humans is 74 days, bearing that in mind, the selected participants were requested to provide two semen samples 74 days apart for their semen analyses. It was observed that 70% of the men who recovered from COVID-19 had reduced total sperm counts post-recovery.Compared to their pre-infection semen analysis reports, a mean reduction of 48.83% was observed in the sperm counts of these men in their first semen analysis post-recovery which was performed 74 days or one spermatogenic cycle after their recovery. The reduction in sperm counts was less pronounced in their second semen analysis, performed 148 days or two spermatogenic cycles after they had recovered. A mean reduction of 12.13% was observed in the sperm counts in their second semen analysis compared to their pre-infection levels.
A mean reduction of 8.31% was observed in the sperm counts of these men between their first and second semen analyses post-recovery.

Limitations, reasons for caution
Given that the findings reported herein are based on limited sample size, the results should therefore be treated with utmost caution. Another limitation of this study is that we did not stratify the participants according to the severity of their infection.

Wider implications of the findings
Subsequent long-term follow-up along with sperm banking is necessitated in Coronavirus disease affected men since long-term andrological after-effects of COVID-19 are not fully understood yet. Future studies should investigate the impact of COVID-19 on the male reproductive hormones involved in the hypothalamus-pituitary-gonadal axis and its impact on sperm DNA.

Trial registration number
Not applicable