Impact of COVID-19 on gender and fertility

The pathophysiology of coronavirus disease 2019 (COVID-19) is associated with a wide range of functional changes in some physiological parameters.

The direct effects of coronavirus 2 (SARS-CoV-2), a severe acute respiratory syndrome on the urogenital organs of men and women, have not yet been determined. Nonetheless, various explanations are provided based on the biological similarities between SARS-CoV and SARS-CoV-2.

study: How did COVID-19 affect sex and fertility? Image Credit: Chinnapong / Shutterstock.com

recently Urology and Men’s Health Trends The study discusses the potential effects of SARS-CoV-2 on sexual activity and fertility.

Genital ACE2 receptor

SARS-CoV-2 mainly infects cells with angiotensin converting enzyme 2 (ACE2) receptors on the surface. In addition to ACE2, transmembrane serine protease 2 (TMPRSS-2) is often required.

Except for the epididymis, ACE2 receptor expression is observed throughout the male reproductive tract, especially in Sertoli cells and sperm stem cells. Previous studies have shown that biopsies taken from the testicles of infertile men have elevated levels of ACE2 receptors in both germ and somatic cells.

According to two recent reviews, the ACE2 receptor is also expressed in the ovary, endometrium, myometrium, dedecidua, and vagina. The trophoblast in early pregnancy, as well as the placenta, chorion, amniotic membrane, and umbilical cord in late pregnancy, have high levels of ACE2 expression.

One study recently showed that ACE2 receptor expression was relatively minimal in tissue samples obtained from female reproductive tract and breast cells, and TMPRSS-2 expression was also minimal or absent. .. Therefore, infection with SAR-CoV-2 is unlikely to occur in the female reproductive tract.

Genital SARS-CoV-2 infection

Several viruses have been detected in sperm samples. However, it is difficult to prove sexual intercourse as a method of viral infection because other viable transmission routes cannot be completely ruled out. In addition, previous studies have shown that the presence of SARS-CoV-2 in the vagina is extremely rare and that only 4 out of 98 women have positive results.

Effect of COVID-19 on sexual activity

The impact of the COVID-19 pandemic, especially on sexual activity during the blockade, is complicated by some circumstances and can vary from country to country. For example, a study conducted in Turkey found that the frequency of sexual activity is increasing but of poor quality throughout the current pandemic.

Various reports in the United Kingdom claim that the frequency and quality of sexual intercourse increased during the blockade of COVID-19, but most of the evidence available supports the opposite. In fact, pandemics have been reported to worsen couples’ sexual lives around the world. This applies to both quantitative factors such as sexual intercourse and foreplay efficacy, duration, and frequency, as well as more subjective aspects such as lubrication, enjoyment, and libido.

Although some publications warn about the possibility COVID-19 infection So far, there is no evidence of this mode of infection through sexual intercourse. Nevertheless, some features of sexual activity increase the likelihood of viral infection. However, sperm maturation can take up to 72 days, so it may remain infectious even after sperm have been removed from other parts of the body. This is especially possible if the antiviral antibody cannot cross the blood-testis barrier.

COVID-19 and fertility

The direct effect of SARS-CoV-2 on sperm remains unknown. All standard World Health Organization (WHO) parameters for semen analysis were significantly impaired in one study, including 84 men with COVID-19 who required hospitalization.

Here, sperm samples were tested every 10 days for up to 60 days, and the amount of semen in infected men was about half that of healthy men. In addition, the rate of progressive motility was reduced by about 50%, which was accompanied by poor morphology. Sperm volume and its motility in each sample improved statistically over time, but these improvements were not clinically significant by 60 days, despite having a significant p-value. was.

SARS-CoV-2 has been shown to damage sperm cells, especially in severe cases. However, the mechanism responsible for this damage remains unclear. One of the prospective studies of infected men found that conception rates were temporarily reduced.

COVID-19, like any other serious illness, causes changes in menstruation. In particular, the period will be longer and the amount will decrease.

To date, no changes in sex hormones have been found in individuals infected with SARS-CoV-2.

In particular, the COVID-19 pandemic is associated with the lowest reproductive rate since 1938. However, COVID-19 itself does not appear to affect the number of births, which is the main determinant of fertility.