SARS-CoV-2 impairs male fertility by targeting semen quality and testosterone level: A systematic review and meta-analysis

PLoS One. 2024 Sep 9;19(9):e0307396. doi: 10.1371/journal.pone.0307396. eCollection 2024.

Abstract

Background: Since the discovery of COVID-19 in December 2019, the novel virus has spread globally causing significant medical and socio-economic burden. Although the pandemic has been curtailed, the virus and its attendant complication live on. A major global concern is its adverse impact on male fertility.

Aim: This study was aimed to give an up to date and robust data regarding the effect of COVID-19 on semen variables and male reproductive hormones.

Materials and methods: Literature search was performed according to the recommendations of PRISMA. Out of the 852 studies collected, only 40 were eligible for inclusion in assessing the effect SARS-CoV-2 exerts on semen quality and androgens. More so, a SWOT analysis was conducted.

Results: The present study demonstrated that SARS-CoV-2 significantly reduced ejaculate volume, sperm count, concentration, viability, normal morphology, and total and progressive motility. Furthermore, SARS-CoV-2 led to a reduction in circulating testosterone level, but a rise in oestrogen, prolactin, and luteinizing hormone levels. These findings were associated with a decline in testosterone/luteinizing hormone ratio.

Conclusions: The current study provides compelling evidence that SARS-CoV-2 may lower male fertility by reducing semen quality through a hormone-dependent mechanism; reduction in testosterone level and increase in oestrogen and prolactin levels.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • COVID-19* / complications
  • COVID-19* / virology
  • Fertility* / physiology
  • Humans
  • Infertility, Male / blood
  • Infertility, Male / physiopathology
  • Infertility, Male / virology
  • Luteinizing Hormone / blood
  • Male
  • SARS-CoV-2* / pathogenicity
  • Semen / physiology
  • Semen Analysis*
  • Sperm Count
  • Sperm Motility / physiology
  • Testosterone* / blood

Substances

  • Luteinizing Hormone
  • Testosterone

Grants and funding

The author(s) received no specific funding for this work.