Immediate and long-term consequences of coronavirus disease 2019 on fertility and androgenic status of men

BACKGROUND: The new coronavirus disease 2019 (COVID-19) recognized as a global pandemic, impacts many human organs and systems. In view of the coronavirus widespread and high incidence of the disease in young men of reproductive potential, It would be relevant to assess the immediate and long-term consequences of coronavirus disease on the reproductive system of men and their hormonal status

AIM: To study of the effect of COVID-19 on the male reproductive system and hormonal status.

MATERIALS AND METHODS: The study included the findings of examination and treatment of 62 men aged 22 to 45 years (mean age: 38.3 ± 3.2 years) who had COVID-19 confirmed by PCR testing within 3-6 months prior to the study. Sixteen (25.8%) men had severe disease, and 46 (74.2%) men suffered from moderate one. All patients enrolled in the study had spermogram parameters, mixed antiglobulin reaction (MAR) test findings and total plasma testosterone levels were within the reference values before the disease. These parameters were determined for all patients after recovery at 6 and 12 months.

RESULTS: Six months after the disease, significant spermatogenesis disorders, manifested by a decreasing concentration and/or mobility and/or the number of normal forms of spermatozoa, leukospermia, were observed in 14 of 16 (87.5%) patients in the severe disease group and in 16 of 46 (34.7%) patients with moderate severity disease (p < 0.05). Total plasma testosterone levels were decreased in all 16 (100%) patients in the severe group and in 32 of 46 (69.6%) patients in the moderate group (p < 0.05). Within 12 months after the disease, significant disorders in the main spermogram parameters were observed in 5 of 16 (31.2%) patients with severe coronavirus disease, and in 4 of 46 (8.7%) patients with moderate coronavirus (p < 0.05). A decrease in total plasma testosterone levels occurred in 10 of 16 (62,5%) men of the severe disease group and in 4 of 46 (8.7%) men with moderate disease (p < 0.05).

CONCLUSIONS: Our findings demonstrate the negative impact of COVID-19 on male fertility and hormonal status. The coronavirus severity mainly determines the rate, intensity and duration of spermatogenesis disorders and hypogonadism manifestations that occur after it.