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.