Clinics (Sao Paulo). 2020;75:e2183.

The interference of COVID-19 in the male reproductive system: Important questions and the future of assisted reproduction techniques

Renata Cristina de Carvalho , Matheus Ferreira Groner , Jacqueline Camillo , Paulo Roberto Abrão Ferreira , Renato Fraietta

DOI: 10.6061/clinics/2020/e2183

COVID-19 AND SEMEN

Due to the pandemic caused by the novel coronavirus disease, researchers internationally have started to utilize their efforts in understanding its pathophysiology and method of action (). Ongoing studies have reported that severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is easily found in most human bodily fluids (-). In relation to semen, there is great interest in unraveling the possible interaction between this fluid sample and the SARS-Cov-2 microorganism, as well as the possible long term consequences of this relationship (). Perhaps the most significant dimension of this theme is related to our current knowledge of other viral infections, in which the causative agents are found in the seminal sample, which use this medium for their transmission while causing alterations in the fertile potential of their carriers (-).

In addition, the form of the SARS-Cov-2 infection that has been established in the literature, and its mechanism of action, are similar to that of the SARS-Cov virus (). Using the cellular receptor angiotensin converting enzyme 2 (ACE2), this virus infiltrates the cells where it then starts its multiplication (,). Interestingly, these receptors are found in high concentrations within the germ and somatic cells of the human testicles (); however, recent studies show that, for the cell infection process to be successful, the transmembrane serine protease 2 (TMPRSS2) protein that assists in the virus-cell fusion process needs to be present (). However, the expression of this molecule is rarely found within testicular tissue (). Thus, there are doubts as to whether the testis is an organ that is vulnerable to this new infection.

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