Dados do Trabalho

Title

Impact of SARS-CoV-2 on seminal parameters of men treated at an Assisted Reproduction Center in Rio Grande do Norte, Brazil

Objective

The objective of this study was to know the impacts of SARS-CoV-2 infection on the seminal parameters of men undergoing assisted reproduction treatment at a maternity school, in a public assisted reproduction center located in Rio Grande do Norte, Brazil.

Methods

After approval by the ethics committee of Universidade Federal do Rio Grande do Norte (number 64207622.5.0000.5537), men who reported having received a positive diagnosis for COVID-19, before or after starting treatment at the assisted reproduction center of Maternidade Escola Januário Cicco (Natal-RN), between the years of 2022 to 2023, were invited to participate in this research. Data were collected from medical records and spermograms of 50 men who agreed to participate in the research, by signing the informed consent form. The medical records were analyzed and important data collected, such as: 1. socio-economic profile of the patient; 2. sperm parameters; 3. reported sperm alterations. The data analysis used a case-control design, in which the control group data was performed according to WHO laboratory manual 6th ed. for the examination and processing of human semen.

Results

A total of 50 patients were included with a mean age ± SD (range) of 36.7 ± 8.94 (29-50) years. Among these, 64% (32/50) performed physical activity one or more times a week. At the beginning of treatment, 80% had no children and 20% had 1 or more children. Regarding sperm parameters, 52% (26/50) had a mean liquefaction time of 20 minutes, 10% (5/50) with a mean time of 40 minutes, 2% (1/50) with 45 minutes and 36% (18/50) with a mean time of 60 minutes. According to WHO, this process usually occurs until 20 minutes, and finishes until 60 minutes after semen collection. The mean semen volume was 2.9 ml, in which 36% (18/50) samples presented volume between 0.5 to 1.5 ml and 16% (8/50) presented volume above 5.0 ml. According to WHO laboratory manual, 1.5 ml is the minimum acceptable value for normospermia, while values above 5 ml characterize hyperspermia. The presence of leukocytes (10^6/ml) was on average 0.1% for the 50 samples, being within the expected value. Linear progressive motility (LPM) value was on average 19%, non-linear progressive motility (NLPM) showed a mean value of 20%, and non-progressive motility (NPM) showed mean value of 4.9%. According to WHO, a value above 32% of LPM + NLPM, and above 40% of PM + NPM is preferred for normal fertility. In this study, respectively, 52% (26/50) and 56% (28/50) of the patients showed sperm motility below the expected values for the sum of LPM + NLPM or PM + NPM, characterizing asthenozoospermia. Immotile spermatozoa value was on average 21%. As for morphology, 22% (11/50) of the sperm had less than 4% of normal morphology. According to WHO, the lower reference limit is 4%. Of these, 65% (33/50) had no other associated diseases and 35% (17/50) had associated diseases, varicocele being the most common (8/17).

Conclusion

It can be concluded that the exposition of SARS-CoV-2 can affect the seminal parameters by reducing the expected values for normospermic men, specially on sperm motility. The existence of previous pathologies does not seem to influence the severity of the condition. This study therefore reinforces the importance of post-COVID-19 seminal evaluation, aiming to increase pregnancy rates in infertile patients, or with marital infertility.

Keywords

COVID-19, infertility, male fertility, semen, sperm