Assessment of SARS-CoV-2 in human semen—a cohort study

COVID-19 does not seem to have any short-term effects on male fertility in patients with mild symptoms. SARS-CoV-2 was not detected in semen of recovered and COVID-19 acute infected men.
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VOLUME 114, ISSUE 2, P233-238

Authors:

Nora Holtmann, M.D., Philippos Edimiris, M.D., Marcel Andree, M.D., Cornelius Doehmen, M.D., Dunja Baston-Buest, Ph.D., Ortwin Adams, M.D., Ph.D., Jan-Steffen Kruessel, M.D., Ph.D., Alexandra Petra Bielfeld, M.D., Ph.D.

Abstract:

Objective

To investigate the presence of viral RNA in human semen of patients with severe acute-respiratory syndrome coronavirus 2 (SARS-CoV-2) and to evaluate its presence and relevance in semen parameters.


Design

Pilot cohort study.


Setting

University hospital.


Patient(s)

Thirty-four men were distributed as: 1) patients in convalescence (patients with confirmed SARS-CoV-2 infection in pharyngeal swab according to reverse-transcription polymerase chain reaction [RT-PCR] or antibodies); 2) negative control group (no antibodies); and 3) patients with an acute infection (detection of SARS-CoV-2 in pharyngeal swab).


Intervention

Semen and a blood sample were collected from each individual.


Main Outcome Measure(s)

Analysis of semen quality according to the World Health Organization standards. Detection of SARS-CoV-2 by RT-PCR in the native semen sample and after density gradient preparation. Confirmation of immunoglobulin (Ig) A und IgG antibodies in the blood.


Result(s)

Eighteen semen samples from recovered men were obtained 8–54 days after absence of symptoms, 14 from control subjects, and 2 from patients with an active COVID-19 infection. No RNA was detected by means of RT-PCR in the semen, including semen samples from two patients with an acute COVID-19 infection. Subjects with a moderate infection showed an impairment of sperm quality.


Conclusion(s)

A mild COVID-19 infection is not likely to affect testis and epididymis function, whereas semen parameters did seem impaired after a moderate infection. SARS-CoV-2 RNA could not be detected in semen of recovered and acute COVID-19–positive men. This suggests no viral transmission during sexual contact and assisted reproductive techniques, although further data need to be obtained.

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Go to the profile of M. Blake Evans
over 2 years ago

Thank you to the authors for an important addition to the literature regarding male infertility and COVID-19. Regarding the decreased semen analysis parameters in those with moderate symptoms, is there a follow up evaluation planned to see if the parameters improve after the typical spermatogenesis timeline has passed?