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Absence of SARS-CoV-2 (COVID-19 virus) within the IVF laboratory using strict patient screening and safety criteria. Reprod Biomed Online 2021; 42:1067-1074. [PMID: 33814309 PMCID: PMC7937039 DOI: 10.1016/j.rbmo.2021.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 12/17/2022]
Abstract
Research question Is there a risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral exposure and potential cross-contamination from follicular fluid, culture media and vitrification solution within the IVF laboratory using strict patient screening and safety measures? Design This was a prospective clinical study. All women undergoing transvaginal oocyte retrieval were required to have a negative SARS-CoV-2 RNA test 3–5 days prior to the procedure. Male partners were not tested. All cases used intracytoplasmic sperm injection (ICSI). The first tube of follicular fluid aspirated during oocyte retrieval, drops of media following removal of the embryos on day 5, and vitrification solution after blastocyst cryopreservation were analysed for SARS-CoV-2 RNA. Results In total, medium from 61 patients, vitrification solution from 200 patients and follicular fluid from 300 patients was analysed. All samples were negative for SARS-CoV-2 viral RNA. Conclusions With stringent safety protocols in place, including testing of women and symptom-based screening of men, the presence of SARS-CoV-2 RNA was not detected in follicular fluid, medium or vitrification solution. This work demonstrates the possibility of implementing a rapid laboratory screening assay for SARS-CoV-2 and has implications for safe laboratory operations, including cryostorage recommendations.
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Abstract
The novel 2019 coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a highly transmissible and pathogenic coronavirus. Because of the novelty of the COVID-19 pandemic, few data are available on the impact of the SARS-CoV-2 on the different endocrine glands. Previous studies of severe acute respiratory syndrome (SARS) have shown a harmful effect on endocrine function. Notably, the angiotensin-converting enzyme-2 receptor, which is the entry route of coronaviruses to the host cell, is widely expressed in the endocrine organs including testis, endocrine pancreas, thyroid, and adrenal, and pituitary glands. Clinical and biochemical manifestations have been recorded in COVID-19 patients resulting in changes in endocrine activities, which were also recorded during the SARS outbreak in 2003. This review aims to explore the impact of SARS-CoV-2 infection on the function of endocrine glands, based on the latest research in the field.
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Affiliation(s)
- Adel Abdel-Moneim
- Molecular Physiology Division, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Ahmed Hosni
- Molecular Physiology Division, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
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103
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Hashem NM, Abdelnour SA, Alhimaidi AR, Swelum AA. Potential impacts of COVID-19 on reproductive health: Scientific findings and social dimension. Saudi J Biol Sci 2021; 28:1702-1712. [PMID: 33519273 PMCID: PMC7831751 DOI: 10.1016/j.sjbs.2020.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 01/15/2023] Open
Abstract
COVID-19 virus is classified as a respiratory disease that can be mainly transmitted via respiratory droplets, however, there are recently published reports suggested its ability to transmit via sexual intercourse, assisted reproductive technology (ART) treatments, pregnancy, and nursing. Although SARS-CoV-2 mainly attacks respiratory systems, manifestations of multiple organs have been detected. A significant concern was raised about whether COVID-19 may affect female and male reproductive functions. These findings imposed more restrictions on social relationships between individuals even if inside the family, adding more physiologic load. In this context, there is a crucial need to identify the biological and behavioral reproductive risk factors associated with COVID-19 disease. Questions regarding the potential risks of sexual transmission during intercourse and/or application of ART, vertical transmission (throughout pregnancy, delivery, and breastfeeding), the health of pregnant and postpartum women, and fetal or postnatal health problems of neonates/children remain largely unanswered. The contribution of individuals to different social and economic activities depends on the maintenance of good quality life and health. The ongoing COVID-19 pandemic raised on the end of December 2019 has drastically affected different aspects of human wellbeing. The pandemic not only affected the health of individuals, but also negatively affected mental health and social interaction. This review illustrates: a) scientific findings related to the impact of the COVID-19 pandemic on the reproductive process, considering gender, hormonal balance, gonad functions, pregnancy, and ART, b) the sociosexual dimension of COVID-19 disease and precautions that should be taken to avoid infection via sexual transmission or vertical transmission, which may alleviate the fear associated with continuing normal social relationships and economic activities.
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Affiliation(s)
- Nesrein M. Hashem
- Animal and Fish Production Department, Faculty of Agriculture (El-Shatby), Alexandria University, Alexandria 21545, Egypt
| | - Sameh A. Abdelnour
- Department of Animal Production, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt
| | - Ahmad R. Alhimaidi
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Ayman A. Swelum
- Department of Animal Production, College of Food and Agriculture Sciences, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia
- Department of Theriogenology, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt
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104
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Seymen CM. Being pregnant in the COVID-19 pandemic: Effects on the placenta in all aspects. J Med Virol 2021; 93:2769-2773. [PMID: 33559937 PMCID: PMC8013594 DOI: 10.1002/jmv.26857] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022]
Abstract
The coronavirus disease 2019 (COVID‐19), which had spread to the world from Wuhan (China) in late December, was announced as a pandemic by the World Health Organization in March 2020. In addition to acute respiratory syndrome symptoms, this virus also affects nonrespiratory organs, according to existing data. ACE2 and TMPRSS2, which play a critical role in the entrance of SARS‐COV‐2 into the cell, are coexpressed in placental development stages, so the placenta also carries a risk for this virus. Many studies have shown that this virus causes some histopathological changes in the placenta. The vertical transmission of the virus is not yet clear, but available data have shown that the indirect effects of the virus can be seen on the fetus. This article focuses on revealing the effects of the virus on the placenta in all aspects. The placenta also shows antiviral activity due to placental growth factors, cytokines, and chemokines, so the use of placental extracts as therapeutic agents in the treatment of COVID‐19 needs authority regulations and clinical guidelines.
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Affiliation(s)
- C Merve Seymen
- Department of Histology and Embryology, Gazi University, Institute of Health Sciences, Ankara, Turkey
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105
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Tur-Kaspa I, Tur-Kaspa T, Hildebrand G, Cohen D. COVID-19 may affect male fertility but is not sexually transmitted: a systematic review. ACTA ACUST UNITED AC 2021; 2:140-149. [PMID: 33558864 PMCID: PMC7857030 DOI: 10.1016/j.xfnr.2021.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 12/12/2022]
Abstract
Objective To determine if SARS-CoV-2, which has led to the rapidly spreading COVID-19 global pandemic, is sexually transmitted. Since the putative receptor for the virus is identified in reproductive organs, it is also important to examine if COVID-19 may affect human fertility. Evidence Review A systematic review of English publications was conducted up to December 11, 2020 in PubMed, NIH iCite COVID-19 portfolio, Cochrane Library, and Google Scholar databases, searching for SARS-CoV-2 in the testes; seminal, prostatic, and vaginal fluids; and cervical smears. A total of 1,997 records were identified, duplicates were removed, and 1,490 records were reviewed for eligibility by examining titles and abstracts. Subsequently, 202 full-text relevant articles were reviewed by 2 independent reviewers. Forty-seven studies (literature reviews, editorials, and guidelines) were assessed qualitatively, and 23 studies that tested the male and female reproductive tracts of patients with COVID-19 for SARS-CoV-2 were quantitatively analyzed. Results No epidemiological investigations to date have described evidence suggesting that COVID-19 is an STD. While angiotensin-converting enzyme 2 receptor is found in the reproductive organs, the lack of co-expression of the TMPRSS2 modulatory protein, required for SARS-CoV-2 cell entry, in testicular cells, sperm, or oocytes, argues against the hypothesis that gametes transmit SARS-CoV-2. Molecular detection studies of SARS-CoV-2 RNA in the male and female reproductive tracts were summarized: 98.0% (293/299) of the seminal fluids, 16/17 testicular biopsies, all 89 prostatic fluids, 98.3% (57/58) of the vaginal fluids, all 35 cervical smears, and all 16 oocyte samples tested negative for SARS-CoV-2. None of the studies confirmed sexual transmission of SARS-CoV-2. Nonetheless, COVID-19 may have detrimental effects on male reproduction by inducing orchitis and/or decreasing testosterone levels, sperm counts, and motility. Conclusion On the basis of the current worldwide published information, COVID-19 is not an STD. This information is important for clinicians, proposed guidelines for public health, U.S. Food and Drug Administration guidelines for gamete and tissue donor eligibility, and fertility treatments. Universal precautions, currently practiced worldwide, are adequate and sufficient at this time to prevent the transmission of known or unknown viral infections. We suggest that recovered patients of COVID-19, especially those with infertility, should be evaluated for their ovarian and testicular function.
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Affiliation(s)
- Ilan Tur-Kaspa
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana
| | - Tomer Tur-Kaspa
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana.,Wesleyan University, Middletown, Connecticut
| | - Grace Hildebrand
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana
| | - David Cohen
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana
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106
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Rajput SK, Logsdon DM, Kile B, Engelhorn HJ, Goheen B, Khan S, Swain J, McCormick S, Schoolcraft WB, Yuan Y, Krisher RL. Human eggs, zygotes, and embryos express the receptor angiotensin 1-converting enzyme 2 and transmembrane serine protease 2 protein necessary for severe acute respiratory syndrome coronavirus 2 infection. F&S SCIENCE 2021; 2:33-42. [PMID: 33521687 PMCID: PMC7831752 DOI: 10.1016/j.xfss.2020.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To study messenger ribonucleic acid (mRNA) and protein expressions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptors (angiotensin 1-converting enzyme 2 [ACE2] and CD147) and proteases (transmembrane serine protease 2 [TMPRSS2] and cathepsin L [CTSL]) in human oocytes, embryos, and cumulus (CCs) and granulosa cells (GCs). DESIGN Research study. SETTING Clinical in vitro fertilization (IVF) treatment center. PATIENTS Patients undergoing IVF were treated at the Colorado Center for Reproductive Medicine. INTERVENTIONS Oocytes (germinal vesicle and metaphase II [MII]) and embryos (1-cell [1C] and blastocyst [BL]) were donated for research at the disposition by the patients undergoing IVF. Follicular cells (CC and GC) were collected from women undergoing egg retrieval after ovarian stimulation without an ovulatory trigger for in vitro maturation/IVF treatment cycles. MAIN OUTCOME MEASURES Presence or absence of ACE2, CD147, TMPRSS2, and CTSL mRNAs detected using quantitative reverse transcription polymerase chain reaction and proteins detected using capillary Western blotting in human oocytes, embryos, and ovarian follicular cells. RESULTS The quantitative reverse transcription polymerase chain reaction analysis revealed high abundance of ACE2 gene transcripts in germinal vesicle and MII oocytes than in CC, GC, and BL. ACE2 protein was present only in the MII oocytes, and 1C and BL embryos, but other ACE2 protein variants were observed in all the samples. TMPRSS2 protein was present in all the samples, whereas mRNA was observed only in the BL stage. All the samples were positive for CD147 and CTSL mRNA expressions. However, CCs and GCs were the only samples that showed coexpression of both CD147 and CTSL proteins in low abundance. CONCLUSIONS CCs and GCs are the least susceptible to SARS-CoV-2 infection because of lack of the required combination of receptors and proteases (ACE2/TMPRSS2 or CD147/CTSL) in high abundance. The coexpression of ACE2 and TMPRSS2 proteins in the MII oocytes, zygotes, and BLs demonstrated that these gametes and embryos have the cellular machinery required and, thus, are potentially susceptible to SARS-CoV-2 infection if exposed to the virus. However, we do not know whether the infection occurs in vivo or in vitro in an assisted reproductive technology setting yet.
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Affiliation(s)
| | | | - Becca Kile
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | | | - Ben Goheen
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Shaihla Khan
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Jason Swain
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Sue McCormick
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | | | - Ye Yuan
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
| | - Rebecca L Krisher
- Colorado Center for Reproductive Medicine, Lone Tree, Colorado
- Genus PLC, DeForest, Wisconsin
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107
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Virant-Klun I, Strle F. Human Oocytes Express Both ACE2 and BSG Genes and Corresponding Proteins: Is SARS-CoV-2 Infection Possible? Stem Cell Rev Rep 2021; 17:278-284. [PMID: 33403489 PMCID: PMC7785127 DOI: 10.1007/s12015-020-10101-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 12/14/2022]
Abstract
In addition to a number of scientific and medical questions about SARS-CoV-2 infection that still need to be answered, there is also the question of how this highly virulent virus and COVID-19 disease affect gametogenesis in humans. Even more important is the question of whether the virus can also enter and infect oocytes and possibly alter them in an unknown way, which could also affect the development and status of the human embryo. The answers to these questions are still poorly known, so we reviewed the human oocyte transcriptome and proteome obtained in our previous studies and found that human oocytes from the in vitro fertilization program expressed both the ACE2 and BSG genes and the corresponding ACE2 and BSG proteins. This means that human oocytes possess the molecular 'machinery' to facilitate SARS-CoV-2 entrance and infection. According to various studies, especially in animal models, different viruses can infect oocytes, so infection of the oocyte with SARS-Cov-2 cannot be completely ruled out. A hypothetical model of human oocyte infection with this virus has been proposed.
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Affiliation(s)
- Irma Virant-Klun
- Clinical Research Center, University Medical Center Ljubljana, Vrazov trg 1, Ljubljana, Slovenia
| | - Franc Strle
- Clinical Research Center, University Medical Center Ljubljana, Vrazov trg 1, Ljubljana, Slovenia
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108
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Barragan M, Guillén JJ, Martin-Palomino N, Rodriguez A, Vassena R. Undetectable viral RNA in oocytes from SARS-CoV-2 positive women. Hum Reprod 2021; 36:390-394. [PMID: 32998162 PMCID: PMC7543480 DOI: 10.1093/humrep/deaa284] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 09/22/2020] [Indexed: 01/05/2023] Open
Abstract
A central concern for the safe provision of ART during the current coronavirus disease 2019 (CODIV-19) pandemic is the possibility of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection through gametes and preimplantation embryos. Unfortunately, data on SARS-CoV-2 viral presence in oocytes of infected individuals are not available to date. We describe the case of two women who underwent controlled ovarian stimulation and tested positive to SARS-CoV-2 infection by PCR on the day of oocyte collection. The viral RNA for gene N was undetectable in all the oocytes analyzed from the two women.
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Affiliation(s)
- M Barragan
- Clinica EUGIN, Carrer de Balmes 236, Barcelona 08006, Spain
| | - J J Guillén
- Clinica EUGIN, Carrer de Balmes 236, Barcelona 08006, Spain
| | | | - A Rodriguez
- Clinica EUGIN, Carrer de Balmes 236, Barcelona 08006, Spain
| | - R Vassena
- Clinica EUGIN, Carrer de Balmes 236, Barcelona 08006, Spain
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109
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Carvalho BRD, Adami KDS, Gonçalves-Ferri WA, Samama M, Ferriani RA, Marcolin AC. COVID-19: Uncertainties from Conception to Birth. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:54-60. [PMID: 33513637 PMCID: PMC10183911 DOI: 10.1055/s-0040-1721856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Scientific information on the impact of the new coronavirus (SARS-CoV-2) on the health of pregnant women, fetuses and newborns is considered of limited confidence, lacking good-quality evidence, and drawing biased conclusions. As a matter of fact, the initial impressions that the evolution of COVID-19 was no different between pregnant and non-pregnant women, and that SARS-CoV-2 was not vertically transmitted, are confronted by the documentation of worsening of the disease during pregnancy, poor obstetric outcomes, and the possibility of vertical transmission. The present article aims to compile the data available on the association of COVID-19 and reproductive events, from conception to birth.
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Affiliation(s)
| | - Karina de Sá Adami
- Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Walusa Assad Gonçalves-Ferri
- Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marise Samama
- Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alessandra Cristina Marcolin
- Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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110
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Morelli F, Meirelles LEDF, de Souza MVF, Mari NL, Mesquita CSS, Dartibale CB, Damke GMZF, Damke E, da Silva VRS, Souza RP, Consolaro MEL. COVID-19 Infection in the Human Reproductive Tract of Men and Nonpregnant Women. Am J Trop Med Hyg 2021; 104:814-825. [PMID: 33534765 PMCID: PMC7941816 DOI: 10.4269/ajtmh.20-1098] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 is an enveloped non-segmented positive-sense RNA virus, classified as a beta coronavirus, responsible for the COVID-19 pandemic. Angiotensin-converting enzyme 2 (ACE2), reported as a SARS-CoV-2 receptor, is expressed in different human tissues (lung, intestine, and kidney) and in the testis, ovaries, uterus, and vagina. This suggests a potential risk to the human reproductive tract in COVID-19 patients. In addition, SARS-CoV-2 RNA has been detected in the blood, urine, facial/anal swabs, semen, and vaginal secretion, suggesting other potential means of transmission. However, little has been reported about SARS-CoV-2 infection in the male and nonpregnant female reproductive tracts, which may provide direct evidence on sexual transmission and fertility problems. Therefore, we focused this narrative review mainly on the distribution of ACE2 and SARS-CoV-2 positivity in the male and nonpregnant female reproductive tracts, providing an overview of the potential threat of COVID-19 to reproductive health and sexual transmission.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Marcia E. L. Consolaro
- Address correspondence to Marcia E. L. Consolaro, Department of Clinical Analysis and Biomedicine, Laboratory of Clinical Cytology and Semen Analysis, State University of Maringá, Av. Colombo, 5790, Zona 7, Maringá 87020-900, Brazil. E-mail:
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111
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Infection precautions for severe acute respiratory syndrome coronavirus 2 in assisted reproduction centers: dodging an invisible bullet. Fertil Steril 2021; 115:831-839. [PMID: 33750621 PMCID: PMC7834468 DOI: 10.1016/j.fertnstert.2021.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/21/2020] [Accepted: 12/21/2020] [Indexed: 01/05/2023]
Abstract
The coronavirus disease 2019 pandemic has resulted in many changes in how we interact in society, requiring that we protect ourselves and others from an invisible, airborne enemy called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Until a vaccine is developed, and it reaches high levels of distribution, everyone must continue to be diligent to limit the viral spread. The practice of assisted reproduction during this pandemic presents unique challenges in addition to the risks identified in general clinical care. The established good tissue practices employed in laboratories are not designed to protect gametes and embryos from an airborne virus, particularly one that may be shed by an asymptomatic staff member. Armed with theoretical risks but lacking direct evidence, assisted-reproduction teams must examine every aspect of their practice, identify areas at a risk of exposure to SARS-CoV-2, and develop a mitigation plan. Several professional fertility societies have created guidelines for the best practices in patient care during the coronavirus disease 2019 pandemic. As we learn more about SARS-CoV-2, updates have been issued to help adapt infection-control and -prevention protocols. This review discusses what is currently known about SARS-CoV-2 infection risks in assisted reproductive centers and recommends the implementation of specific mitigation strategies.
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112
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Selvaraj K, Ravichandran S, Krishnan S, Radhakrishnan RK, Manickam N, Kandasamy M. Testicular Atrophy and Hypothalamic Pathology in COVID-19: Possibility of the Incidence of Male Infertility and HPG Axis Abnormalities. Reprod Sci 2021; 28:2735-2742. [PMID: 33415647 PMCID: PMC7790483 DOI: 10.1007/s43032-020-00441-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/16/2020] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19), which resulted from the pandemic outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a massive inflammatory cytokine storm leading to multi-organ damage including that of the brain and testes. While the lungs, heart, and brain are identified as the main targets of SARS-CoV-2-mediated pathogenesis, reports on its testicular infections have been a subject of debate. The brain and testes are physiologically synchronized by the action of gonadotropins and sex steroid hormones. Though the evidence for the presence of the viral particles in the testicular biopsies and semen samples from COVID-19 patients are highly limited, the occurrence of testicular pathology due to abrupt inflammatory responses and hyperthermia has incresingly been evident. The reduced level of testosterone production in COVID-19 is associated with altered secretion of gonadotropins. Moreover, hypothalamic pathology which results from SARS-CoV-2 infection of the brain is also evident in COVID-19 cases. This article revisits and supports the key reports on testicular abnormalities and pathological signatures in the hypothalamus of COVID-19 patients and emphasizes that testicular pathology resulting from inflammation and oxidative stress might lead to infertility in a significant portion of COVID-19 survivors. Further investigations are required to monitor the reproductive health parameters and HPG axis abnormalities related to secondary pathological complications in COVID-19 patients and survivors.
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Affiliation(s)
- Kaviya Selvaraj
- School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India.,Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Sowbarnika Ravichandran
- School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India.,Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Sushmita Krishnan
- School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Risna Kanjirassery Radhakrishnan
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Nivethitha Manickam
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Mahesh Kandasamy
- School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India. .,Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India. .,Faculty Recharge Programme, University Grants Commission (UGC-FRP), New Delhi, 110002, India.
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113
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SARS-CoV-2 and the reproductive system: known and the unknown..!! MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021; 26:1. [PMID: 33437145 PMCID: PMC7789900 DOI: 10.1186/s43043-020-00046-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background COVID-19 is the most recent zoonotic outbreak of coronaviruses. Mostly, it invades the cells of the respiratory system by binding to the receptor angiotensin-converting enzyme 2 (ACE2) which is also present in other organs like the kidney, testis, ovaries, breast, heart, and intestine, rendering them prone to be infected. The reproductive potential is a must for the sustenance of any species and it is our prime duty to safeguard the reproductive system of the present generation from such a deadly virus. The previously reported coronaviruses like severe acute respiratory syndrome coronavirus (SARS-CoV) had a detrimental impact on reproductive organs. There is a dearth of sufficient research to provide substantial evidence for the harmful effects of this novel virus on the reproductive system. Hence, our review compiles the knowledge available until now to boost research in this regard and to take the necessary steps in time. Main body of abstract Here we tried to compile all the data available on the effect of SARS-CoV-2 on the reproductive system as well as vertical transmission of the virus. All related articles published from February to August 2020 were reviewed and thoroughly analyzed. SARS-CoV-2 has been found to affect the sperm concentration and motility, thus degrading the fertility of males. In females, it is suspected that this virus affects the oocyte quality and ovarian function, resulting in infertility or miscarriage. Traces of SARS-CoV-2 virus have also been found in the breast milk of the infected mothers and the semen of infected males. Vertical transmission of SARS-CoV-2 has also been reported in some cases. Conclusion Based on the literature review, SARS-CoV-2 seems to have the potential of affecting both male and female reproductive tracts. This review brings together the findings and observations made in the area of reproductive health during the current pandemic. The reproductive system of the young population is preordained for subsequent disorders, infertility, reduced sperm count, and motility. Therefore, the research and medical practices should focus on possible vulnerability being posed by SARS-CoV-2 to the gametes and future generations. We, hereby, recommend close monitoring of young and pregnant COVID-19 patients concerning reproductive health with utmost priority.
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114
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Gröner MF, de Carvalho RC, Camillo J, Ferreira PRA, Fraietta R. Effects of Covid-19 on male reproductive system. Int Braz J Urol 2021; 47:185-190. [PMID: 33047924 PMCID: PMC7712710 DOI: 10.1590/s1677-5538.ibju.2021.99.04] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Matheus Ferreira Gröner
- Universidade Federal de São PauloDisciplina de UrologiaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Renata Cristina de Carvalho
- Universidade Federal de São PauloDisciplina de UrologiaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Jacqueline Camillo
- Universidade Federal de São PauloDisciplina de UrologiaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Paulo Roberto Abrão Ferreira
- Universidade Federal de São PauloDisciplina de InfectologiaDepartamento de MedicinaSão PauloSPBrasilDepartamento de Medicina, Disciplina de Infectologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
| | - Renato Fraietta
- Universidade Federal de São PauloDisciplina de UrologiaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Disciplina de Urologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brasil
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115
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Patel DP, Punjani N, Guo J, Alukal JP, Li PS, Hotaling JM. The impact of SARS-CoV-2 and COVID-19 on male reproduction and men's health. Fertil Steril 2021; 115:813-823. [PMID: 33509629 PMCID: PMC7775791 DOI: 10.1016/j.fertnstert.2020.12.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 01/08/2023]
Abstract
Many couples initially deferred attempts at pregnancy or delayed fertility care due to concerns about coronavirus disease 2019 (COVID-19). One significant fear during the COVID-19 pandemic was the possibility of sexual transmission. Many couples have since resumed fertility care while accepting the various uncertainties associated with severe acute respiratory syndrome coronavirus 2, including the evolving knowledge related to male reproductive health. Significant research has been conducted exploring viral shedding, tropism, sexual transmission, the impact of male reproductive hormones, and possible implications to semen quality. However, to date, limited definitive evidence exists regarding many of these aspects, creating a challenging landscape for both patients and physicians to obtain and provide the best clinical care. This review provides a comprehensive assessment of the evolving literature concerning COVID-19 and male sexual and reproductive health, and guidance for patient counseling.
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Affiliation(s)
- Darshan P Patel
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Nahid Punjani
- Center for Male Reproductive Medicine and Microsurgery, Department of Urology, Weill Cornell Medicine of Cornell University, New York, New York
| | - Jingtao Guo
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Joseph P Alukal
- Department of Urology, Columbia University Medical Center, New York, New York
| | - Philip S Li
- Center for Male Reproductive Medicine and Microsurgery, Department of Urology, Weill Cornell Medicine of Cornell University, New York, New York
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
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116
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Omolaoye TS, Adeniji AA, Cardona Maya WD, du Plessis SS. SARS-COV-2 (Covid-19) and male fertility: Where are we? Reprod Toxicol 2021; 99:65-70. [PMID: 33249233 PMCID: PMC7689309 DOI: 10.1016/j.reprotox.2020.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 12/26/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), a single-stranded RNA virus, was found to be the causal agent of the disease called coronavirus disease. During December 2019, China informed the World Health Organization (WHO) of an outbreak of cases of pneumonia of unknown etiology, which caused severe-acute respiratory distress. The disease was termed coronavirus disease 2019 (Covid-19). Due to alarming levels of spread and severity, on the 11th of March 2020, the WHO declared the outbreak as a global pandemic. As of September 14, 2020, more than 29 million cases have been reported, with over 900,000 deaths globally. Since the outbreak, although not conclusive, discoveries have been made regarding the understanding of the epidemiology, etiology, clinical features, clinical treatment, and prevention of the disease. SARS-COV-2 has been detected in saliva, respiratory fluids, blood, urine, and faeces. Findings are however controversial regarding its presence in the semen or the testis. Hence, this review aimed to further analyse the literature concerning (i) the effects of previously identified human coronaviruses on male fertility (ii) the impact of Covid-19 on male fertility and (iii) the implication for general health in terms of infection and transmission.
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Affiliation(s)
- Temidayo S Omolaoye
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Adeloye A Adeniji
- Division of Family Medicine and Primary Care, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; Ceres Hospital, Cape Winelands Health District, Department of Health, Ceres, South Africa
| | - Walter D Cardona Maya
- Reproduction Group, Department of Microbiology and Parasitology, Medical School, University of Antioquia, Colombia
| | - Stefan S du Plessis
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa; Department of Basic Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
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117
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Guo J, Sheng K, Wu S, Chen H, Xu W. An Update on the Relationship of SARS-CoV-2 and Male Reproduction. Front Endocrinol (Lausanne) 2021; 12:788321. [PMID: 34887838 PMCID: PMC8649688 DOI: 10.3389/fendo.2021.788321] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 10/29/2021] [Indexed: 12/29/2022] Open
Abstract
Since the outbreak of the COVID-19, up to now, infection cases have been continuously rising to over 200 million around the world. Male bias in morbidity and mortality has emerged in the COVID-19 pandemic. The infection of SARS-CoV-2 has been reported to cause the impairment of multiple organs that highly express the viral receptor angiotensin-converting enzyme 2 (ACE2), including lung, kidney, and testis. Adverse effects on the male reproductive system, such as infertility and sexual dysfunction, have been associated with COVID-19. This causes a rising concern among couples intending to have a conception or who need assisted reproduction. To date, a body of studies explored the impact of SARS-CoV-2 on male reproduction from different aspects. This review aims to provide a panoramic view to understand the effect of the virus on male reproduction and a new perspective of further research for reproductive clinicians and scientists.
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Affiliation(s)
- Juncen Guo
- Sichuan University-The Chinese University of Hong Kong (SCU-CUHK) Joint Laboratory for Reproductive Medicine, Key Laboratory of Obstetric, Gynaecologic and Paediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, Department of Obstetric and Gynaecologic, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Kai Sheng
- Department of Orthopedic Surgery, Shriners Hospital for Children, Montreal, QC, Canada
- Orthopaedic Research Laboratory, Department of Orthopedic Surgery, McGill University, Montreal, QC, Canada
| | - Sixian Wu
- Sichuan University-The Chinese University of Hong Kong (SCU-CUHK) Joint Laboratory for Reproductive Medicine, Key Laboratory of Obstetric, Gynaecologic and Paediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, Department of Obstetric and Gynaecologic, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Hanxiao Chen
- Sichuan University-The Chinese University of Hong Kong (SCU-CUHK) Joint Laboratory for Reproductive Medicine, Key Laboratory of Obstetric, Gynaecologic and Paediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, Department of Obstetric and Gynaecologic, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Wenming Xu
- Sichuan University-The Chinese University of Hong Kong (SCU-CUHK) Joint Laboratory for Reproductive Medicine, Key Laboratory of Obstetric, Gynaecologic and Paediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
- Reproductive Endocrinology and Regulation Laboratory, Department of Obstetric and Gynaecologic, West China Second University Hospital, Sichuan University, Chengdu, China
- *Correspondence: Wenming Xu,
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118
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Dutta S, Sengupta P. SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology. Reprod Sci 2021; 28:23-26. [PMID: 32651900 PMCID: PMC7351544 DOI: 10.1007/s43032-020-00261-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/03/2020] [Indexed: 01/08/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) has been declared a pandemic by the World Health Organization (WHO) on 11th March 2020. Bulk of research on this virus are carried out to unveil its multivariate pathology. Surprisingly, men are reportedly more vulnerable to COVID-19 even with higher fatality rate compared to women. Thus, it is crucial to determine whether SARS-CoV-2 infection can even affect male fertility as an immediate or long-term consequence of the disease. Among the discrete data available, an important finding is that angiotensin converting enzymes 2 (ACE2) receptor, that aids the SARS-CoV-2 entry into host cells, is profoundly expressed in testicular cells. In addition, the endogenous androgen milieu and its receptors are associated with ACE2 activation reflecting that enhanced testosterone levels may trigger the pathogenesis of COVID-19. In contrary, hypogonadism has also been reported in the acute phase of some COVID-19 cases. Moreover, SARS-CoV-2 infection-induced uncontrolled inflammatory responses may lead to systemic oxidative stress (OS), whose severe disruptive effects on testicular functions are well-documented. This article aims to precisely present the possible impact of COVID-19 on male reproductive functions, and to highlight the speculations that need in-depth research for the exact underlying mechanisms how COVID-19 is associated with men's health and fertility.
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Affiliation(s)
- Sulagna Dutta
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Petaling Jaya, Malaysia
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Petaling Jaya, Malaysia.
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119
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Teixeira TA, Oliveira YC, Bernardes FS, Kallas EG, Duarte-Neto AN, Esteves SC, Drevet JR, Hallak J. Viral infections and implications for male reproductive health. Asian J Androl 2021; 23:335-347. [PMID: 33473014 PMCID: PMC8269834 DOI: 10.4103/aja.aja_82_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Viral infections have haunted humankind since times immemorial. Overpopulation, globalization, and extensive deforestation have created an ideal environment for a viral spread with unknown and multiple shedding routes. Many viruses can infect the male reproductive tract, with potential adverse consequences to male reproductive health, including infertility and cancer. Moreover, some genital tract viral infections can be sexually transmitted, potentially impacting the resulting offspring's health. We have summarized the evidence concerning the presence and adverse effects of the relevant viruses on the reproductive tract (mumps virus, human immunodeficiency virus, herpes virus, human papillomavirus, hepatitis B and C viruses, Ebola virus, Zika virus, influenza virus, and coronaviruses), their routes of infection, target organs and cells, prevalence and pattern of virus shedding in semen, as well as diagnosis/testing and treatment strategies. The pathophysiological understanding in the male genital tract is essential to assess its clinical impact on male reproductive health and guide future research.
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Affiliation(s)
- Thiago A Teixeira
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, University of São Paulo, São Paulo 05403-000, SP, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo 05508-060, SP, Brazil.,Division of Urology, School of Medicine, Federal University of Amapa, Macapa 68903-419, AP, Brazil
| | - Yasmin C Oliveira
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, School of Medicine, Federal University of Amapa, Macapa 68903-419, AP, Brazil
| | - Felipe S Bernardes
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, University of São Paulo, São Paulo 05403-000, SP, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo 05508-060, SP, Brazil
| | - Esper G Kallas
- Department of Infectious and Parasitic Diseases, University of São Paulo, São Paulo 05403-000, SP, Brazil
| | - Amaro N Duarte-Neto
- BIAS - Brazilian Image Autopsy Study Group, Department of Pathology, University of São Paulo, São Paulo 05403-000, SP, Brazil
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas 13075-460, SP, Brazil.,Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas 13083-968, SP, Brazil.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus 8000, Denmark
| | - Joël R Drevet
- GReD Institute, CNRS-INSERM-Université Clermont Auvergne, Faculty of Medicine, Clermont-Ferrand 63000, France
| | - Jorge Hallak
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, University of São Paulo, São Paulo 05403-000, SP, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo 05508-060, SP, Brazil.,Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, São Paulo 05403-000, SP, Brazil
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120
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Nateghi R, Ghashghaei S, Shokoohian B, Hezavehei M, Abbaszadeh M, Ebrahimi B, Shahverdi A, Mashayekhi M, Shpichka A, Timashev P, Nasr-Esfahani MH, Vosough M. Female Reproductive Health in SARS-CoV-2 Pandemic Era. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2021; 15:241-245. [PMID: 34913290 PMCID: PMC8530213 DOI: 10.22074/ijfs.2021.534956.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/03/2021] [Indexed: 11/28/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic struck global health systems with overgrowing demands in many fields of health care; yet, reproductive care, particularly pregnancy care remains a special focus of interest. Pregnancy is a major physiologic change that alters temporarily normal function of many organs, and specifically the immune system. Therefore, pregnant women are more susceptible to respiratory pathogens compared to the others. The current pandemic may have serious consequences on pregnancy whether directly or indirectly. In the present review, direct and indirect possible adverse effects of SARS-CoV-2 infection on female reproductive system by focusing on pregnancy and delivery has been discussed in details. In addition, the pregnancy consequences and whether maternal infection can affect infants were deliberated. The adverse impact of luck down and related psychological complications and obesity on pregnant women were discussed as well. Finally, the effects of SARS-CoV-2 vaccination on maternal health and pregnancy outcome was analyzed.
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Affiliation(s)
- Reihaneh Nateghi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Shahriar Ghashghaei
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR,
Tehran, Iran
| | - Bahare Shokoohian
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Maryam Hezavehei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Mahkameh Abbaszadeh
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR,
Tehran, Iran
| | - Bita Ebrahimi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Abolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Mehri Mashayekhi
- Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Iran, Tehran
| | - Anastasia Shpichka
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia,P.O.Box: 1665659911Department of Reproductive Bio-
technologyReproductive Biomedicine Research CenterRoyan Institute for BiotechnologyACECRIsfahanIranP.O.Box: 16635-148Department of Regenerative MedicineCell Science Research
CentreRoyan Institute for Stem Cell Biology and TechnologyACECRTehranIran
Emails:,
| | - Mohammad Hossein Nasr-Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR,
Isfahan, Iran,P.O.Box: 1665659911Department of Reproductive Bio-
technologyReproductive Biomedicine Research CenterRoyan Institute for BiotechnologyACECRIsfahanIranP.O.Box: 16635-148Department of Regenerative MedicineCell Science Research
CentreRoyan Institute for Stem Cell Biology and TechnologyACECRTehranIran
Emails:,
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR,
Tehran, Iran,P.O.Box: 1665659911Department of Reproductive Bio-
technologyReproductive Biomedicine Research CenterRoyan Institute for BiotechnologyACECRIsfahanIranP.O.Box: 16635-148Department of Regenerative MedicineCell Science Research
CentreRoyan Institute for Stem Cell Biology and TechnologyACECRTehranIran
Emails:,
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121
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Abstract
Information on the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has amplified quickly since its spread; however, many issues remain unclear. SARS-CoV-2 is mainly transmitted through respiratory secretions. However, the potential for SARS-CoV-2 sexual transmission by semen is worthy of study. The cell-receptors of SARS-CoV-2, the angiotensin-converting enzyme-2 receptors, are highly expressed in human testis and may enable this virus to cause testicular tissue damage with bad effect on male fertility. SARS-CoV-2 presentation ranges from asymptomatic carriage to acute respiratory distress and fatal pneumonia, and elderly persons with underlying comorbidities usually suffer from a severe clinical picture. Asymptomatic individuals can spread the virus through their respiratory secretions and possibly through sexual transmission. SARS-CoV-2 can persist viable if cryopreserved in semen samples in sperm cryobankes. As far as I know, there is a gap in knowledge about SARS-CoV-2 transmission through semen, indicating the need for further research. This review attempts to understand the SARS-CoV-2 sexual transmission by semen. One recent study confirmed the theoretical risk of SARS-CoV-2 transmission by semen, but few studies negate this theory. Given that, an increasing number of asymptomatic and reactivated SARS-CoV-2 cases are being reported, attention to semen safety and SARS-CoV-2 transmission should be considered particularly in high-risk areas, to ensure the safety of male gametes for artificial reproduction and the general public. Avoiding cryopreservation of male gametes, condom use or even abstinence might be of paramount importance for these persons.
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122
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Hinting A, Agustinus, Pakpahan C. A Review of the Impact of COVID-19 on Male Reproduction, and its Implications on Assisted Reproductive Technology Services. FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s2661318220300081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became an established pandemic in 2020. The presence of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in male reproductive organ are considered as a potential for susceptibility of these organs to SARS-CoV-2 infection. Review: Spermatogonia are the only cells that express ACE2 and TMPRSS2 in the testis, but the cells which co-express both genes are rare (0.05% of cells). Based on this co-expression, sperm are unlikely to be susceptible to infection by SARS-CoV-2. However, the co-expression of receptor basigin (BSG/CD147) and cathepsin L (CTSL) in primary spermatocytes, Leydig cells, myoid cells, endothelial cells, and spermatogonia might increase the testicular susceptibility to this viral infection. Testicular pain and discomfort have been reported in coronavirus disease 2019 (COVID-19) patients. Postmortem examination also reported seminiferous tubular injury, reduced Leydig cells, and mild lymphocytic inflammation in COVID-19 patients. Compensated hypogonadism has been documented while the impact of COVID-19 on the semen quality is inconclusive. There is only one study that reported the presence of SARS-CoV-2 RNA in semen but, is not supported by other studies with better methods. The association between SARS-CoV-2 and assisted reproductive technology (ART) outcome is surrounded by some uncertainties. Recommendations have been made to reduce the risk of viral transmission to patients, staff, gametes, and embryos. Summary: There is no definite correlation between SARS-CoV-2 infection and male reproductive system. However, a high level of vigilance is still required in services which involve the reproductive system.
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Affiliation(s)
- Aucky Hinting
- Andrology Specialist Program, Department of Medical Biology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina—Center for Reproductive Medicine, Surabaya, Indonesia
| | - Agustinus
- Andrology Specialist Program, Department of Medical Biology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina—Center for Reproductive Medicine, Surabaya, Indonesia
- RSUD Dr Soetomo, Surabaya, Indonesia
| | - Cennikon Pakpahan
- Andrology Specialist Program, Department of Medical Biology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina—Center for Reproductive Medicine, Surabaya, Indonesia
- RSUD Dr Soetomo, Surabaya, Indonesia
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123
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Sheikhzadeh Hesari F, Hosseinzadeh SS, Asl Monadi Sardroud MA. Review of COVID-19 and male genital tract. Andrologia 2020; 53:e13914. [PMID: 33236375 PMCID: PMC7744899 DOI: 10.1111/and.13914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/16/2022] Open
Abstract
COVID‐19 pandemic leads to health challenges globally, and its diverse aspects need to be uncovered. Multi‐organ injuries have been reported by describing potential SARS‐CoV‐2 entrance routes: ACE2 and TMPRSS2. Since these cell surface receptors’ expression has been disclosed within the male reproductive system, its susceptibility to being infected by SARS‐CoV‐2 has been summarised through this literature review. Expression of ACE2 and TMPRSS2 at RNA or protein level has been reported across various investigations indicates that the male genitalia potentially is vulnerable to SARS‐CoV‐2 infection. Presence of SARS‐CoV‐2 within semen samples and following direct viral damage, secondary inflammatory response causing orchitis or testicular discomfort and finally the amount of viral load leading testicular damage and immune response activation are among probable underlying mechanisms. Therefore, genital examination and laboratory tests should be considered to address the male reproductive tract complications and fertility issues.
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124
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Ruan Y, Hu B, Liu Z, Liu K, Jiang H, Li H, Li R, Luan Y, Liu X, Yu G, Xu S, Yuan X, Wang S, Yang W, Ye Z, Liu J, Wang T. No detection of SARS-CoV-2 from urine, expressed prostatic secretions, and semen in 74 recovered COVID-19 male patients: A perspective and urogenital evaluation. Andrology 2020; 9:99-106. [PMID: 33150723 DOI: 10.1111/andr.12939] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/28/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has been spreading all over the world since December 2019. However, medical information regarding the urogenital involvement in recovered COVID-19 patients is limited or unknown. OBJECTIVES To comprehensively evaluate urogenital involvement in recovered COVID-19 patients. MATERIALS AND METHODS Men aged between 20 years and 50 years who were diagnosed with SARS-CoV-2 infection and recovered when the study was conducted were enrolled in our study. Demographic and clinical characteristics, and history of hospitalization were collected and analyzed. Urine, expressed prostatic secretions (EPSs), and semen samples were collected for SARS-CoV-2 RNA detection. Semen quality and hormonal profiles were analyzed. RESULTS Among 74 male recovered COVID-19 patients, 11 (14.9%) were asymptomatic, classified into mild type, and 31 (41.9%) were classified into moderate type. The remaining patients (32/74, 43.2%) had severe pneumonia. No critically ill recovered COVID-19 patient was recruited in our cohort. The median interval between last positive pharyngeal swab RT-PCR test and semen samples collection was 80 days (IQR, 64-93). The median age was 31 years (IQR, 27-36; range, 21-49), and the median body mass index (BMI) was 24.40 (IQR, 22.55-27.30). Forty-five (61.6%) men were married, and 28 (38.4%) were unmarried. Fifty-three (72.6%) patients denied cigarette smoking, 18 (24.7%) were active smokers, and 2 of them were past smokers. The majority of our participants (53/74, 72.6%) did not consume alcohol. Fever occurred in most of the patients (75.3%), and 63 of them had abnormal chest CT images. Only one patient complained of scrotal discomfort during the course of COVID-19, which was ruled out orchitis by MRI (data not shown). A total of 205 samples were collected for SARS-CoV-2 detection (74 urine samples, 70 semen samples, and 61 EPS samples). However, viral nucleic acid was not detected in body fluids from the urogenital system. In terms of hormonal profiles, the levels of FSH, LH, testosterone, and estradiol were 5.20 [4.23] mIU/mL, 3.95 [1.63] mIU/mL, 3.65 [1.19] ng/mL, and 39.48 [12.51] pg/mL, respectively. And these values were within the normal limits. The overall semen quality of recovered COVID-19 patients was above the lower reference limit released by the WHO. While compared with healthy control, sperm concentration, total sperm count, and total motility were significantly declined. In addition, different clinical types of COVID-19 have no significant difference in semen parameters, but total sperm count showed a descending trend. Interestingly, subjects with a longer recovery time showed worse data for sperm quality. Small sample size and lacking semen parameters before the infection are the major limitations of our study. DISCUSSION AND CONCLUSIONS To the best of our knowledge, it is the largest cohort study with longest follow-up for urogenital evaluation comprehensively so far. Direct urogenital involvement was not found in the recovered COVID-19 male patients. SARS-CoV-2 RNA was undetectable in the urogenital secretions, and semen quality declined slightly, while hormonal profiles remained normal. Moreover, patients with a long time (≥90 days) since recovery had lower total sperm count. Great attention and further study should be conducted and follow-up on the reproductive function in the following months.
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Affiliation(s)
- Yajun Ruan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bintao Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongyang Jiang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Luan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaming Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gan Yu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengfei Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyi Yuan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weimin Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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125
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Seymen CM. The other side of COVID-19 pandemic: Effects on male fertility. J Med Virol 2020; 93:1396-1402. [PMID: 33200417 PMCID: PMC7753442 DOI: 10.1002/jmv.26667] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 12/11/2022]
Abstract
The outbreak of novel coronavirus disease 2019 (COVID-19) has become a major pandemic threat worldwide. According to the existing clinical data, this virus not only causes respiratory diseases and affects the lungs but also induces histopathological or functional changes in various organs like the testis and also the male genital tract. The renin-angiotensin system (RAS), also ACE 2 and TMPRSS2 play an important role in the cellular entry for SARS-CoV-2. Because the male genital system presents high ACE 2 expression, the importance of this pathway increases in COVID-19 cases. As the COVID-19 pandemic has affected the male genital system in direct or indirect ways and showed a negative impact on male reproduction, this paper focuses on the possible mechanisms underlying the damage caused by COVID-19 to the testis and also other components of the male genital tract.
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Affiliation(s)
- Cemile Merve Seymen
- Department of Histology and Embryology, Gazi University Institute of Health Sciences, Tunus Street, No:35, Ankara, 06540, Turkey
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126
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Navarra A, Albani E, Castellano S, Arruzzolo L, Levi-Setti PE. Coronavirus Disease-19 Infection: Implications on Male Fertility and Reproduction. Front Physiol 2020; 11:574761. [PMID: 33312128 PMCID: PMC7704452 DOI: 10.3389/fphys.2020.574761] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/08/2020] [Indexed: 12/19/2022] Open
Abstract
The pandemic caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has led to several concerns on male fertility. Nowadays, there are numerous unanswered questions, for example: is the virus present or not in the seminal fluid of infected subjects? Could the seminal fluid represent a way of sexual transmission for the virus? Why do men appear to be more susceptible than women? Several studies have been carried out to ascertain the presence of SARS-CoV-2 in the seminal fluid, with contrasting results; the expression of angiotensin-converting enzyme-2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in the testes and in the male genital tract led to speculation about the possible presence of the virus in the seminal fluid. However, it was found that ACE2 and TMPRSS2, used by the virus to enter host cells, are expressed differently in certain testicle cells (stem germ cells, Leydig and Sertoli cells), yet the testicle cells in which ACE2 and TMPRSS2 molecules are simultaneously expressed are rare. This fact would suggest that the virus is not able to enter testicular cells, that it is not present in the seminal fluid and that it cannot infect male germ cells. However, the direct influence of SARS-CoV-2 on the testes is still to be evaluated, and recent results are very controversial. SARS-CoV-2 could enter the testicle using alternative paths and lead to alterations in testicular functionality. Another plausible consideration is that the COVID-19 disease could also indirectly cause alterations to testicular activity, since the fever and the cytokinic storm generated by the immune system can lead to damage of the testicular activity, consequently compromising male fertility. Although the literature provides controversial evidence, the purpose of this review is to lend a general overview about the state of the art. Despite the lack of studies, it would represent a starting point for further investigation about the effect of this coronavirus on male fertility.
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127
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Zahra A, Sisu C, Silva E, De Aguiar Greca SC, Randeva HS, Chatha K, Kyrou I, Karteris E. Is There a Link between Bisphenol A (BPA), a Key Endocrine Disruptor, and the Risk for SARS-CoV-2 Infection and Severe COVID-19? J Clin Med 2020; 9:E3296. [PMID: 33066495 PMCID: PMC7602132 DOI: 10.3390/jcm9103296] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023] Open
Abstract
Infection by the severe acute respiratory syndrome (SARS) coronavirus-2 (SARS-CoV-2) is the causative agent of a new disease (COVID-19). The risk of severe COVID-19 is increased by certain underlying comorbidities, including asthma, cancer, cardiovascular disease, hypertension, diabetes, and obesity. Notably, exposure to hormonally active chemicals called endocrine-disrupting chemicals (EDCs) can promote such cardio-metabolic diseases, endocrine-related cancers, and immune system dysregulation and thus, may also be linked to higher risk of severe COVID-19. Bisphenol A (BPA) is among the most common EDCs and exerts its effects via receptors which are widely distributed in human tissues, including nuclear oestrogen receptors (ERα and ERβ), membrane-bound oestrogen receptor (G protein-coupled receptor 30; GPR30), and human nuclear receptor oestrogen-related receptor gamma. As such, this paper focuses on the potential role of BPA in promoting comorbidities associated with severe COVID-19, as well as on potential BPA-induced effects on key SARS-CoV-2 infection mediators, such as angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). Interestingly, GPR30 appears to exhibit greater co-localisation with TMPRSS2 in key tissues like lung and prostate, suggesting that BPA exposure may impact on the local expression of these SARS-CoV-2 infection mediators. Overall, the potential role of BPA on the risk and severity of COVID-19 merits further investigation.
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Affiliation(s)
- Aeman Zahra
- Biosciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (A.Z.); (C.S.); (E.S.); (S.-C.D.A.G.)
| | - Cristina Sisu
- Biosciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (A.Z.); (C.S.); (E.S.); (S.-C.D.A.G.)
| | - Elisabete Silva
- Biosciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (A.Z.); (C.S.); (E.S.); (S.-C.D.A.G.)
| | - Sophie-Christine De Aguiar Greca
- Biosciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (A.Z.); (C.S.); (E.S.); (S.-C.D.A.G.)
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; (H.S.R.); (I.K.)
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B4 7ET, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
| | - Kamaljit Chatha
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
- Department of Biochemistry and Immunology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; (H.S.R.); (I.K.)
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B4 7ET, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
| | - Emmanouil Karteris
- Biosciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK; (A.Z.); (C.S.); (E.S.); (S.-C.D.A.G.)
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128
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Huang C, Ji X, Zhou W, Huang Z, Peng X, Fan L, Lin G, Zhu W. Coronavirus: A possible cause of reduced male fertility. Andrology 2020; 9:80-87. [PMID: 32960504 PMCID: PMC7537192 DOI: 10.1111/andr.12907] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 01/08/2023]
Abstract
In lately December 2019, a novel coronavirus (SARS-CoV-2) outbreak occurred in Wuhan, PR China. It is a high contagious virus that has threatened human health worldwide. SARS-CoV-2 infection, termed COVID-19, causes rapidly developing lung lesions that can lead to multiple organ failure in a short period. Whenever a novel virus emerges, reproductive risk assessments should be performed after infection. In this review, we show that male fertility might be damaged by coronavirus associated with (i) direct cytopathic effects derived from viral replication and viral dissemination in the testis; and (ii) indirect damage to male fertility derived from immunopathology. In this review, we briefly describe the impaired fertility of humans and animals infected with coronaviruses to deduce the impact of the new coronavirus on male fertility. Together with information related to other coronaviruses, we extrapolate this knowledge to the new coronavirus SARS-CoV-2, which may have a significant impact on our understanding of the pathophysiology of this new virus.
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Affiliation(s)
- Chuan Huang
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Xiren Ji
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Wenjun Zhou
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China
| | - Zhenghui Huang
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Xiangjie Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Liqing Fan
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
| | - Wenbing Zhu
- Institute of Reproductive and Stem Cell Engineering, Basic Medicine College, Central South University, Changsha, China.,Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
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129
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Jirge PR, Patwardhan S, Jirge SN, Bhomkar DA, Chougule SM, Salpekar A, Modi D. Resuming Assisted Reproduction Services during COVID-19 Pandemic: An Initial Indian Experience. J Hum Reprod Sci 2020; 13:323-332. [PMID: 33627983 PMCID: PMC7879848 DOI: 10.4103/jhrs.jhrs_211_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The pandemic of COVID-19 has affected many countries and medical services including assisted reproductive treatment (ART) have been hampered. AIM The study was conducted to assess the preparedness of ART clinics and staff to resume services; patients' reasons to initiate treatment; and key performance indicators (KPIs) of ART laboratories during the pandemic. SETTING AND DESIGN This was a semidescriptive, prospective study in two private in vitro fertilization (IVF) clinics in Maharashtra, India, when COVID-19 testing for asymptomatic people was unavailable. MATERIALS AND METHODS Time required for replenishing consumables and clinic preparedness to function under "new norms" of pandemic was documented. Infection mitigation measures and triaging strategy were evaluated. KPIs following resumption were analyzed. The Student's t-test was performed for comparing parameters. RESULTS Thirty percent of the patients consulted through telemedicine accepted or were eligible to initiate treatment on clinic resumption. Lack of safe transport and financial constraints prevented majority from undergoing IVF, and 9% delayed treatment due to fear of pandemic. With adequate training, staff compliance to meet new demands was achieved within a week, but procuring consumables and injections was time-consuming. Fifty-two cycles of IVF were performed including fresh and frozen embryo transfers with satisfactory KPIs even during pandemic. Conscious sedation and analgesia during oocyte retrieval were associated with reduced procedure time and no intervention for airway maintenance compared to general anesthesia. Self-reported pain scores by patients ranged from nil to mild on a graphic rating scale. CONCLUSIONS This study provides practical insight for the resumption of IVF services during the COVID-19 pandemic.
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Affiliation(s)
- Padma Rekha Jirge
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Sadhana Patwardhan
- Department of Reproductive Medicine, Nagpur Test Tube Baby Centre, Nagpur, India
| | - Shishir Narendra Jirge
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Deepali A. Bhomkar
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Shruti M. Chougule
- Department of Reproductive Medicine, Sushrut Assisted Conception Clinic & Shreyas Hospital, Kolhapur, India
| | - Anita Salpekar
- Department of Reproductive Medicine, Nagpur Test Tube Baby Centre, Nagpur, India
| | - Deepak Modi
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Rproductive Health, Mumbai, Maharashtra, India
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130
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Pascolo L, Zito G, Zupin L, Luppi S, Giolo E, Martinelli M, De Rocco D, Crovella S, Ricci G. Renin Angiotensin System, COVID-19 and Male Fertility: Any Risk for Conceiving? Microorganisms 2020; 8:E1492. [PMID: 32998451 PMCID: PMC7601043 DOI: 10.3390/microorganisms8101492] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/08/2020] [Accepted: 09/25/2020] [Indexed: 01/08/2023] Open
Abstract
The current knowledge concerning the connection between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the renin-angiotensin system (RAS) system in the male reproductive apparatus is still limited, so dedicated studies are urgently required. Concerns about the male fertility consequences of SARS-CoV-2 infection have started to emerge, since epidemiologic studies observed that this coronavirus affects male patients more frequently and with increased severity, possibly because of the hormone-regulated expression of angiotensin-converting enzyme 2 (ACE2) receptor. A disturbance in fertility is also expected based on studies of the previous SARS-CoV infection, which targets the same ACE2 receptor when entering the host cells. In addition, bioinformatics analyses reveal the abundant expression of ACE2 receptor in the male reproductive tissues, particularly in the testis. It has been proposed that pharmacological intervention favoring the angiotensin-(1-7)/ACE2/Mas receptor pathway and increasing ACE2 expression and activity could greatly prevent inflammatory lesions in this area. Finally, in laboratories performing assisted reproductive technologies it is recommended that more attention should be paid not only to sperm quality but also to safety aspects. Data about the potential infectivity of seminal fluid are in fact conflicting and do not exclude risks for both personnel and patients. The potential infectivity of SARS-CoV-2 in reproductive male tissues should be strongly considered and further investigated for the proper management of in vitro fertilization procedures.
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Affiliation(s)
- Lorella Pascolo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Gabriella Zito
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Luisa Zupin
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Stefania Luppi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Elena Giolo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Monica Martinelli
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Daniela De Rocco
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
| | - Sergio Crovella
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy; (S.L.); (E.G.); (M.M.); (D.D.R.); (S.C.); (G.R.)
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34137 Trieste, Italy
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131
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Zupin L, Pascolo L, Zito G, Ricci G, Crovella S. SARS-CoV-2 and the next generations: which impact on reproductive tissues? J Assist Reprod Genet 2020; 37:2399-2403. [PMID: 32783136 PMCID: PMC7419027 DOI: 10.1007/s10815-020-01917-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/03/2020] [Indexed: 12/24/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) is a severe global pandemic, affecting mostly the respiratory system. Understandably, attention is also being directed towards the urogenital tract. In this work, expression patterns of various host molecules possibly involved in viral entry and replication were investigated in human female and male reproductive systems by inquiring online repositories, including the Human Protein Atlas, GTEx, FANTOM5. Our findings highlight that male reproductive tissues could be targeted by SARS-CoV-2, particularly the testis since it co-expresses the receptor (ACE2) and the protease (TMPRSS) needed for viral entry. We hypothesized that SARS-CoV-2 infection could have repercussions on the fertility status of male individuals Potential infectivity of SARS-CoV-2 in reproductive tissues should be considered in reproductive medicine and management of in vitro fertilization in present and future generations.
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Affiliation(s)
- Luisa Zupin
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Lorella Pascolo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Gabriella Zito
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Giuseppe Ricci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.,Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Sergio Crovella
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.,Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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132
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Entezami F, Samama M, Dejucq-Rainsford N, Bujan L. SARS-CoV-2 and human reproduction: An open question. EClinicalMedicine 2020; 25:100473. [PMID: 32734175 PMCID: PMC7378472 DOI: 10.1016/j.eclinm.2020.100473] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 01/21/2023] Open
Affiliation(s)
- Frida Entezami
- American Hospital of Paris, IVF Department, 63 boulevard Victor Hugo, 92200 Neuilly sur Seine, France
- Inserm U1203, Human Early Embryonic Development and Pluripotency, Montpellier, France
- Corresponding author at: American Hospital of Paris, IVF Department, 63 boulevard Victor Hugo, 92200 Neuilly sur Seine, France.
| | - Marise Samama
- Department of Gynecology, Federal University of São Paulo, Brazil
- GERA Institute of Reproductive Medicine, São Paulo, Brazil
| | | | - Louis Bujan
- Research Group on Human Fertility EA 3694, University Paul Sabatier Toulouse III and CECOS, Hôpital Paule de Viguier CHU de Toulouse, Toulouse, France
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133
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Massarotti C, Garolla A, Maccarini E, Scaruffi P, Stigliani S, Anserini P, Foresta C. SARS-CoV-2 in the semen: Where does it come from? Andrology 2020; 9:39-41. [PMID: 32533891 PMCID: PMC7323151 DOI: 10.1111/andr.12839] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/30/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022]
Abstract
Background The recent report of SARS‐CoV‐2 presence in semen samples of six patients, including two subjects who were recovering from the clinical disease, re‐opened the discussion on possible male genital tract infection, virus shedding in semen, sexual transmission and safety of fertility treatments during the pandemic period. Objectives To explore current data and hypothesis on the possible sites of SARS‐CoV‐2 infection in the male reproduction system. Materials and methods We reviewed the current literature to describe: a) the evidences on angiotensin‐converting enzyme 2 (AC2E) and transmembrane serine protease 2 (TMPRSS2) expression in the testes, accessory glands (including prostate) and the urinary tract; b) other coronaviruses’ (SARS and MERS) ability to infect these sites. Results The co‐expression of both ACE2 and TMPRSS2 genes was reported in spermatogonial stem cells, elongated spermatids, in at least a small percentage of prostate hillock cells and in renal tubular cells. Testicular damage was described in autopsies of SARS patients, without evidence of the virus in the specimens. Prostate is a known infection site for MERS‐CoV. SARS‐CoV‐2 was detected in urines. Discussion There are still al lot of open questions on the effects of SARS‐CoV‐2 infection on the male reproductive tract. The presence of receptors is not a proof that the testis provides a site for viral infection and it is still unknown if SARS‐CoV‐2 is capable to pass the blood‐testis barrier. The possibility of a prostate involvement has not been investigated yet: we have no data, but theoretically it cannot be excluded. Moreover, the RNA detected in semen could have been just a residual of urinary shedding. Conclusion Opening our prospective beyond the testis could be the key to better understand the possibility of a semen‐related viral transmission as well as COVID19 short and long‐term effects on male reproductive function.
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Affiliation(s)
- Claudia Massarotti
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Elena Maccarini
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Paola Scaruffi
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Sara Stigliani
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Paola Anserini
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
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134
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Bahadur G, Homburg R, Yoong W, Singh C, Bhat M, Kotabagi P, Acharya S, Huirne J, Doreski PA, Łukaszuk M, Muneer A. Adverse outcomes in SAR-CoV-2 (COVID-19) and SARS virus related pregnancies with probable vertical transmission. JBRA Assist Reprod 2020; 24:351-357. [PMID: 32662955 PMCID: PMC7365544 DOI: 10.5935/1518-0557.20200057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
The global severe acute respiratory syndrome-related coronavirus SARS-CoV-2 (COVID-19) pandemic has had an unprecedented impact on all aspects of daily life and healthcare. Information on the infection risks for pregnant women and their offspring have so far been limited to small case series, until a large UK report on 427 SARS-CoV-2 infected pregnant women was published. Previous SARS epidemic experiences were drawn upon. Diagnostic use of real time polymerase chain reaction (RT-PCR) and IgG and IgM antibody tests are fraught with concerns of non-validation and false negative results, as are sampling methodologies. Virtually no information on controls accompany these reports. Infection of the mother and baby has serious implications for obstetric and neonatal care. Information on early and late stage pregnancy infection and the relationship to severity of infection on fetal development is both useful and clearly warranted. An increasing number of reports centre around mildly infected women showing no evidence of fetal infection while a few reports suggesting vertical transmission require further validation. Vertical transmission from mother to baby however small would have profound health implications for obstetric and neonatal care and fetal abnormalities. Some data suggesting intrapartum vertical transmission from mother to baby cannot be dismissed given the lack of controls and limitations of diagnostic viral tests. This analysis covers some key early reports addressing pregnancy outcomes following SARS-CoV-2 infection.
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Affiliation(s)
- Gulam Bahadur
- Reproductive Medicine Unit, Obstetrics & Gynaecology Department, North Middlesex University Hospitals Trust, London UK
- Homerton Fertility Centre, Homerton University Hospital. London, UK
| | - Roy Homburg
- Homerton Fertility Centre, Homerton University Hospital. London, UK
| | - Wai Yoong
- Reproductive Medicine Unit, Obstetrics & Gynaecology Department, North Middlesex University Hospitals Trust, London UK
| | - Cheentan Singh
- Neonatal and Peadiatric Unit, North Middlesex University London. London, UK
| | - Mamta Bhat
- Ayrshire Fertility Unit, University Hospital Crosshouse, Kilmarnock, Scotland
| | - Phalguni Kotabagi
- Reproductive Medicine Unit, Obstetrics & Gynaecology Department, North Middlesex University Hospitals Trust, London UK
| | - Santanu Acharya
- Ayrshire Fertility Unit, University Hospital Crosshouse, Kilmarnock, Scotland
| | - Judith Huirne
- University Medical Centers Amsterdam, Research Institute Reproduction and Development. Amsterdam, The Netherlands
| | | | | | - Asif Muneer
- University College London Hospital NIHR Biomedical Research Centre. London, UK
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135
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Fraietta R, Pasqualotto FF, Roque M, Taitson PF. SARS-COV-2 and Male Reproductive Health. JBRA Assist Reprod 2020; 24:347-350. [PMID: 32510901 PMCID: PMC7365526 DOI: 10.5935/1518-0557.20200047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 01/08/2023] Open
Abstract
Critical challenges for the public and private health, research, and medical communities have been posed by the COVID-19 outbreak. Some of these challenges are related to the possible adverse effects of SARS-CoV-2 on male reproductive health, and whether other potential modes of transmission may occur, such as sexual transmission. Moreover, concerns have been raised in terms of whether the COVID-19 outbreak may have an impact on fertility worldwide. In this study, we will discuss the origins of SARS-CoV-2. We will further describe its mechanism of action, diagnosis, symptoms, and potential effects on the male reproductive system.
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Affiliation(s)
- Renato Fraietta
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fábio Firmbach Pasqualotto
- Department of Health Sciences, School of Medicine, University of Caxias do Sul, Caxias do Sul, RS, Brazil
| | - Matheus Roque
- Department of Reproductive Medicine, Mater Prime, São Paulo, Brazil
| | - Paulo Franco Taitson
- Discipline of Human Reproduction, Institute of Biological Sciences and Health, Pontifical Catholic University of Minas Gerais, Brazil
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136
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COVID-19 and andrology: Recommendations of the French-speaking society of andrology (Société d'Andrologie de langue Française SALF). Basic Clin Androl 2020; 30:10. [PMID: 32685170 PMCID: PMC7355134 DOI: 10.1186/s12610-020-00106-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) metamorphosed our medical practice. In early June 2020, more than 6,400,000 COVID-19 (coronavirus-19 disease) cases were diagnosed across the world and more than 380,000 deaths were linked to COVID-19. Many medical symptoms of COVID-19 were reported. We will focus, here, on potential impacts of COVID-19 on men’s andrological health. Our society (French-speaking society of andrology, SALF) also emitted some recommendations in the andrological management of men infected by SARS-CoV-2. First, considering the fever and the potential presence of SARS-CoV2 in semen, SALF recommends waiting for 3 months (duration of one spermatogenesis cycle and epididymal transit) before re-starting ART in the case of men diagnosed COVID-19 positive. Whatever the nature of testosterone and COVID-19 relationships, we recommend an andrological examination, sperm parameters, and hormonal evaluation at the time of the COVID-19 is diagnosed, and several months later. Furthermore, we are concerned by the potential morbid-mortality of the COVID-19, which mainly affects men. This “andrological bias”, if proven, must be reduced by specific andrological diagnosis, therapeutic and prophylactic measures. Research in this direction must be substantiated and financially supported over the next few months (years).
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137
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Abhari S, Kawwass JF. Endometrial susceptibility to SARS CoV-2: explained by gene expression across the menstrual cycle? Fertil Steril 2020; 114:255-256. [PMID: 32741461 PMCID: PMC7324322 DOI: 10.1016/j.fertnstert.2020.06.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Sina Abhari
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
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138
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Borrás A, Guimerà M, Barral Y, Agustí I, Manau Trullàs MD. [SARS-CoV-2 pandemic and assisted reproduction]. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2020; 47:96-105. [PMID: 32834306 PMCID: PMC7303616 DOI: 10.1016/j.gine.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 01/10/2023]
Abstract
La pandemia por el nuevo virus SARS-CoV-2 ha provocado un proceso de adaptación a la nueva situación por parte de toda de la sociedad y, con ello, los centros de reproducción asistida. Tras la fase aguda de la crisis sanitaria, en la que se redujo de forma drástica la actividad, se han reanudado los ciclos, guiados por las recomendaciones de las sociedades científicas. En este artículo revisamos toda la información publicada respecto al virus y el sistema reproductivo, señalando la presencia de enzima convertidora de angiotensina tipo ii(angiotensin-converting enzyme 2, ACE2) en el sistema reproductivo femenino y masculino, a nivel testicular, ovárico, endometrial y a nivel embrionario. Además, realizamos un análisis comparativo entre las recomendaciones de las sociedades científicas en cuanto al cribado de la infección, las normas de funcionamiento y las medidas generales de laboratorio.
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Affiliation(s)
- A Borrás
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - M Guimerà
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - Y Barral
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - I Agustí
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
| | - M D Manau Trullàs
- Unidad de Reproducción Humana Asistida, Servicio de Ginecología, Institut Clínic de Ginecología, Obtetricia i Neonatologia (ICGON), Hospital Clínic de Barcelona, Barcelona, España
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139
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SARS-CoV-2 infection risk assessment in the endometrium: viral infection-related gene expression across the menstrual cycle. Fertil Steril 2020; 114:223-232. [PMID: 32641214 PMCID: PMC7298504 DOI: 10.1016/j.fertnstert.2020.06.026] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 01/08/2023]
Abstract
Objective To determine the susceptibility of the endometrium to infection by—and thereby potential damage from—SARS-CoV-2. Design Analysis of SARS-Cov-2 infection-related gene expression from endometrial transcriptomic data sets. Setting Infertility research department affiliated with a public hospital. Patient(s) Gene expression data from five studies in 112 patients with normal endometrium collected throughout the menstrual cycle. Intervention(s) None. Main Outcome Measure(s) Gene expression and correlation between viral infectivity genes and age throughout the menstrual cycle. Result(s) Gene expression was high for TMPRSS4, CTSL, CTSB, FURIN, MX1, and BSG; medium for TMPRSS2; and low for ACE2. ACE2, TMPRSS4, CTSB, CTSL, and MX1 expression increased toward the window of implantation. TMPRSS4 expression was positively correlated with ACE2, CTSB, CTSL, MX1, and FURIN during several cycle phases; TMPRSS2 was not statistically significantly altered across the cycle. ACE2, TMPRSS4, CTSB, CTSL, BSG, and MX1 expression increased with age, especially in early phases of the cycle. Conclusion(s) Endometrial tissue is likely safe from SARS-CoV-2 cell entry based on ACE2 and TMPRSS2 expression, but susceptibility increases with age. Further, TMPRSS4, along with BSG-mediated viral entry into cells, could imply a susceptible environment for SARS-CoV-2 entry via different mechanisms. Additional studies are warranted to determine the true risk of endometrial infection by SARS-CoV-2 and implications for fertility treatments.
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140
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Carvalho BRD, Rosa-e-Silva ACJDS, Ferriani RA, Reis RMD, Silva de Sá MF. COVID-19 and Assisted Reproduction: A Point of View on the Brazilian Scenario. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2020; 42:305-309. [PMID: 32604432 PMCID: PMC10418301 DOI: 10.1055/s-0040-1713795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
| | | | - Rui Alberto Ferriani
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Rosana Maria dos Reis
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcos Felipe Silva de Sá
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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141
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Blumenfeld Z. Possible impact of COVID-19 on fertility and assisted reproductive technologies. Fertil Steril 2020; 114:56-57. [PMID: 32622412 PMCID: PMC7245206 DOI: 10.1016/j.fertnstert.2020.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 10/26/2022]
Affiliation(s)
- Zeev Blumenfeld
- Reproductive Endocrinology, Obstetrics and Gynecology, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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142
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de Carvalho RC, Groner MF, Camillo J, Ferreira PRA, Fraietta R. The interference of COVID-19 in the male reproductive system: Important questions and the future of assisted reproduction techniques. Clinics (Sao Paulo) 2020; 75:e2183. [PMID: 32876112 PMCID: PMC7442377 DOI: 10.6061/clinics/2020/e2183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/22/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Renata Cristina de Carvalho
- Disciplina de Urologia, Departamento de Cirurgia, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Matheus Ferreira Groner
- Disciplina de Urologia, Departamento de Cirurgia, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, BR
| | - Jacqueline Camillo
- Disciplina de Urologia, Departamento de Cirurgia, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, BR
| | - Paulo Roberto Abrão Ferreira
- Disciplina de Infectologia, Departamento de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, BR
| | - Renato Fraietta
- Disciplina de Urologia, Departamento de Cirurgia, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, BR
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