Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.
Asian J Androl. 2023 May-Jun;25(3):382-388. doi: 10.4103/aja202250.
Coronavirus disease 2019 (COVID-19) has yet to be proven to alter male reproductive function, particularly in the majority of mild/asymptomatic patients. The purpose of this study was to explore whether mild/asymptomatic COVID-19 affects semen quality and sex-related hormone levels. To find suitable comparative studies, a systematic review and meta-analysis was done up to January 22, 2022, by using multiple databases (Web of Science, PubMed, and Embase). Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify and choose the studies. Meta-analysis was used to examine the semen parameters and sex-related hormones of mild/asymptomatic COVID-19 patients before and after infection. The effects of semen collection time, fever, and intensity of verification on semen following infection were also investigated. A total of 13 studies (n = 770) were included in the analysis, including three case-control studies, six pre-post studies, and four single-arm studies. A meta-analysis of five pre-post studies showed that after infection with COVID-19, sperm concentration (I = 0; P = 0.003), total sperm count (I = 46.3%; P = 0.043), progressive motility (I = 50.0%; P < 0.001), total sperm motility (I = 76.1%; P = 0.047), and normal sperm morphology (I = 0; P = 0.001) decreased. Simultaneously, a systematic review of 13 studies found a significant relationship between semen collection time after infection, inflammation severity, and semen parameter values, with fever having only bearing on semen concentration. Furthermore, there was no significant difference in sex-related hormone levels before and after infection in mild/asymptomatic patients. Mild/asymptomatic COVID-19 infection had a significant effect on semen quality in the short term. It is recommended to avoid initiating a pregnancy during this period of time.
新型冠状病毒病（COVID-19）尚未被证明会改变男性生殖功能，尤其是在大多数轻症/无症状患者中。本研究旨在探讨轻症/无症状 COVID-19 是否会影响精液质量和与性相关的激素水平。为了找到合适的对照研究，我们进行了系统评价和荟萃分析，检索了截至 2022 年 1 月 22 日的多个数据库（Web of Science、PubMed 和 Embase）。采用 Preferred Reporting Items for Systematic Reviews and Meta-Analyses（PRISMA）指南进行研究的识别和选择。使用荟萃分析来研究感染前后轻症/无症状 COVID-19 患者的精液参数和与性相关的激素。还研究了精液采集时间、发热和检测强度对感染后精液的影响。共纳入 13 项研究（n = 770），包括 3 项病例对照研究、6 项前后研究和 4 项单臂研究。对 5 项前后研究的荟萃分析表明，感染 COVID-19 后，精子浓度（I = 0；P = 0.003）、总精子数（I = 46.3%；P = 0.043）、前向运动精子（I = 50.0%；P < 0.001）、总精子活力（I = 76.1%；P = 0.047）和正常精子形态（I = 0；P = 0.001）下降。同时，对 13 项研究的系统评价发现，感染后精液采集时间、炎症严重程度与精液参数值之间存在显著关系，发热仅与精子浓度有关。此外，轻症/无症状患者感染前后与性相关的激素水平无显著差异。轻症/无症状 COVID-19 感染对精液质量有短期显著影响。建议在此期间避免怀孕。
