COVID-19 may affect sperm production process, lead to low count, claims study

COVID-19 is considered to be a respiratory condition that affects the lungs and airways. However, in the past few months, researchers have found that the disease can affect multiple organs including the kidneys, heart and testes and may lead to organ damage and failure or even death.Men, in particular, are suggested to be more susceptible to the disease. Experts say this may be due to higher levels of ACE2 in their blood and testes, higher testosterone levels and the presence of a single X chromosome (as compared to women who have two X chromosomes).Now, a new study done in China indicates that SARS-CoV-2 may affect the process of spermatogenesis (sperm formation) and lead to low sperm count.The findings of the study are published in the open-access journal EClinical Medicine that is published by The Lancet.Previous researchSeveral viral diseases are known to affect the male reproductive system. These include the hepatitis C virus, human immunodeficiency virus (HIV,) Herpes virus, Ebola virus and human papillomavirus. These viruses affect spermatogenesis, sperm count, hormone levels and sperm motility.Experts suggest that high body temperature during viremia (presence of the virus in the blood) may cause the virus to cross the blood-testis barrier and leak into the male reproductive tract. However, the researchers say that the virus may not need to be present inside the male reproductive tract to cause damage.SARS-CoV-2, the causative agent of COVID-19, has also been shown to be present in the male gonads. When it comes to the effects of the virus on the male reproductive tract, not much information is available yet.The latest studyFor the current research, the scientists looked into two different cohorts. In the first cohort, autopsy samples were taken from six men who died of COVID-19 and semen samples from 23 men who were recovering from the disease. For the control group, six surgical samples were taken from men with prostate cancer and 22 semen samples were taken from healthy men.All the men included in the test groups were above 18 years of age, had tested positive for COVID-19 infection within the past seven days, never got treatment for infertility, already had children through natural pregnancy or did not have any children due to an identified fertility problem of their wife and had no history of a disease that could affect the sperm production process.Here are some of the findings of the study:

• Interstitial oedema was seen in both the testes and epididymis in all the men with COVID-19.
• Spermatogenesis process was seen to be affected in all the test subjects.
• COVID-19 patients had a higher concentration of T cells and macrophages in their testicular tissue. 
• IgG, a type of antibody that is produced later in the infection, was seen in the six autopsy samples. 
• ACE2 expression was seen in testicular cells. 
• About nine out of the 23 semen samples from recovering COVID-19 patients had a sperm concentration of less than 15 x 106/mL. Normal sperm count ranges from 15 X 106 to 20 X 106/mL. Again, all these men had had children before and were never treated for infertility. 
• About 14 patients showed a leukocyte count of more than 1 x 106/mL indicating leucocytospermia, a condition characterized by the presence of high leukocyte count inside the semen and the resultant damage of sperm DNA.  

For more information, read our article on Low Sperm Count. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.