COVID-19 infection may reduce fertility in men: study

PARIS, France - COVID-19 may damage sperm quality and reduce fertility in men, according to a new study based on experimental evidence.

The viral disease -- which has swept the globe, claiming nearly 2.2 million lives -- can cause increased sperm cell death, inflammation and so-called oxidative stress, researchers reported Friday in the journal Reproduction. 

"These findings provide the first direct experimental evidence that the male reproductive system could be targeted and damaged by COVID-19," the authors concluded.

Experts commenting on the research, however, said the capacity of the virus to compromise fertility in men remains unproven.

COVID-19 causes respiratory illness, especially in older people and those with underlying medical problems.

The world has seen more than 100 million confirmed cases since the disease emerged in central China at the end of 2019.

Transmitted through respiratory droplets, the disease attacks the lungs, kidneys, intestines and heart. 

It can also infect male reproductive organs, impairing sperm cell development and disrupting reproductive hormones, earlier studies have shown. The same receptors the virus uses to access lung tissue are also found in the testicles.

But the effects of the virus on the ability of men to reproduce remained unclear.

Behzad Hajizadeh Maleki and Bakhtyar Tartibian from Justus-Liebig-University in Germany searched for biological markers that might indicate a negative impact on fertility. 

Analysis done at 10-day intervals for 60 days in 84 men with Covid-19 was compared to data for 105 healthy men. 

In the Covid-19 patients, sperm cells showed a significant increase in markers of inflammation and oxidative stress, a chemical imbalance that can damage DNA and proteins in the body.

STRONG NOTE OF CAUTION

"These effects on sperm cells are associated with lower sperm quality and reduced fertility potential," said Maleki in a statement. 

"Although these effects tended to improve over time, they remained significantly and abnormally higher in the Covid-19 patients."

The more severe the disease, the bigger the changes, he added.

The male reproductive system "should be considered a vulnerable route of Covid-19 infection and declared a high-risk organ by the World Health Organization," Maleki said.

Experts not involved in the study welcomed the research, but cautioned that more was needed before drawing hard and fast conclusions.

"Men should not be unduly alarmed," noted Alison Campbell, director of embryology of the CARE Fertility Group in Britain. 

"There is currently no definitive evidence of long-lasting damage caused by Covid-19, to sperm or male reproductive potential," she told the London-based Science Media Centre.

The results could have been skewed, she added, by the fact that men recovering from Covid were treated with corticosteroids and antiviral therapies, while the control group was not.

Allan Pacey, a specialist in male reproductive medicine at the University of Sheffield, raised a "strong note of caution" on how the data was interpreted.

Some of the indicators of decreased sperm quality could be due to factors besides Covid-19, he said, noting that more men in the Covid-19 group were overweight.

The simple fact that only one group was very sick -- no matter the cause -- also needed to be taken into account, he added.

"We already know that a febrile illness can impact on sperm production, regardless of what caused it."

Agence France-Presse

France may face sperm shortage under Macron plan to ease IVF rules

PARIS—France risks a shortage of frozen sperm if lawmakers approve new legislation that allows single women and lesbian couples access to in-vitro fertilization (IVF) and abolishes the right of sperm and egg donors to keep their identities secret, clinicians said.

Lawmakers in the country's National Assembly on Tuesday start debating a bioethics bill that unwinds some of western Europe's strictest rules governing medically-assisted pregnancies, a campaign promise of President Emmanuel Macron.

Under existing law in France, IVF is available only to opposite-sex couples, and only for reasons of infertility or the risk of transmission of a disease or medical condition to the child or either parent.

Health Minister Agnes Buzyn forecasts a roughly two-thirds increase in demand for IVF procedures, with an extra 2,000 women annually registering for treatment.

Couples already wait an average of 12 months from registration to their first attempt at IVF. Clinicians at France's network of public sperm banks (CECOS) said the supply of cryopreserved sperm only just meets demand.

Moreover, they predict lifting donor anonymity could prompt three-quarters of registered male and female donors to deny clinics the use of their sperm and eggs under the new rules.

"To say 'everything is going to be ok' would be burying your head in the sand," Nathalie Rives, president of the CECOS federation, told Reuters.

"There will be a period of instability, with increased demand and the need to recruit new donors. We don't know how long this instability will last and whether there will be a shortage."

The bioethics bill, which would also allow women to freeze their eggs for non-medical reasons to enhance their chances of having children, is Macron's first major societal reform.

Medically assisted reproduction—such as IVF—is widely available to all women in countries such as Britain, Belgium and Spain. But in France, it has fed into a broader debate about the commercialization of healthcare and gay rights.

"The right to know one’s origins is a vital right, a fundamental right,” said Arthur Kermalvezen, 35, who turned to DNA tests to track down his biological father and has campaigned for the lifting of anonymity.

The legalization of gay marriage in France 6 years ago sparked massive street protests even though the influence of the Catholic Church was thought to be in decline.

In a sign France has become more socially liberal, polls show a majority of French people back the bioethics reform.

Professor Rachel Levy, who runs the CECOS center at the Tenon Hospital in Paris, said donor anonymity would remain in place for 13 months after the legislation comes into effect in an effort to help sperm banks build up stocks.

There would then be a second phase during which existing donors would say if they consent to their cryopreserved sperm being used under the new rules. The samples of those who refuse will be destroyed later.

"It's a challenging situation," Levy said.

source: news.abs-cbn.com