A scoping review of SARS-CoV-2 and male infertility: Concerns and future prospects

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been detected in the blood, urine, facial/anal swabs, semen, and vaginal discharge; all have been shown to contain SARS-CoV-2 RNA. Recent findings have highlighted the prospect of SARS-CoV-2 invading the genital system in addition to other tissues, which might give rise to reproductive concerns. This investigation sheds light on male reproductive tract vulnerability to invasion by SARS-CoV-2 and provides a foundation for further researches into male fertility. Males are infected with COVID-19 at a higher rate than females. As a result, some data suggest that this viral infection might affect the male reproductive system. The probable causes for male genital tract abnormalities in COVID- 19 are: 1) high expression of angiotensin-converting enzyme 2 in the testes; 2) SARS-CoV-2 infection indirectly induces immune response in the testes; 3) SARS-CoV-2 directly damages male genital cells by virus-receptor binding activity; 4) fever in SARS-CoV-2 infected males may cause damages to testicular cells; 5) testosterone level decreased in SAR-CoV-2 infected males; 6) males are more susceptible to COVID-19 than females, which may be due to differences in the physiology of the genital tract. This review seeks to offer some insights into the potential causes of COVID-19 that affect the male reproductive system, as well as future prospect on this issue.