Impact of COVID-19 disease on the male factor in reproductive medicine – how-to advise couples undergoing IVF/ICSI

Abstract

Context The COVID-19 pandemic has caused widespread concern about its potential impact on various aspects of human health. Aims This narrative review aims to summarise the current knowledge about the impact of COVID-19 on sperm quality and its effect on assisted reproductive technology. Methods In this narrative review, a literature search using the PubMed and MEDLINE databases was conducted to identify relevant original research articles published up to 29 January 2023. Results Thirty original studies were included in our review. There is evidence that SARS-CoV-2 is detectable in seminal fluid during the acute phase of infection and for up to 1 month. However, the fact that SARS-CoV-2 is barely detectable in semen makes sexual transmission very unlikely. COVID-19 infection has been associated with the following changes in sperm quality: morphology, altered motility, changed DNA fragmentation-index (DFI), decreased sperm concentration, lower total number of sperm, and a significant increase in leukocytes and cytokines. The effects mostly seem to be reversible and have not been shown to negatively affect the outcome of assisted reproductive technology but should lead to further research concerning the health of the offspring, because a correlation of increased DFI after COVID-19 even 5 months after disease could be assumed. Conclusions The findings of this narrative review suggest that SARS-CoV-2 may harm sperm quality in the acute phase. Implications A recovery time of at least 3 months regarding assisted reproductive therapy could be reasonable.