16 March 2020

Laura Riggall By

Appeared in BioNews 1039

A report published online that suggests the novel coronavirus may lead to male infertility has now been removed.

The piece, which was published on the Hubei government's website and widely shared on Chinese social media before being retracted, claimed that men who had contracted and recovered from the disease should seek medical advice to determine whether the virus had affected their fertility.

'Clinicians should pay attention to the risk of testicular lesions in patients during hospitalisation and later clinical follow-up, especially the assessment and appropriate intervention in young patients' fertility,' the report stated.

Produced by a team based at the Reproductive Medicine Centre at Tongji Hospital in Wuhan, China, the report said it was theoretically possible that COVID-19 could impact men's reproductive health, as a receptor that the virus is thought to use to infect human cells, called angiotensin-converting enzyme 2 (ACE2), is also highly expressed in the testes.

However, the team did not perform a study to assess male fertility in patients who had been infected with the coronavirus, and there is no evidence to suggest that the virus is found in the testes. Furthermore, the article was published in medRxiv, a website where researchers share data that has not been peer-reviewed in order to engage in discussion with other researchers.

Speaking to Newsweek, Professor Allan Pacey, a leading expert in male fertility at the University of Sheffield, emphasised that the article is a 'short discussion' paper that has not been peer-reviewed and 'highly theoretical.'

'It is intended to alert the medical and scientific community to the possible impact COVID-19 may have on the male reproductive system,' he said. 'At present it is somewhat premature to conclude from this study [that] COVID-19 will definitely affect male fertility, but it is useful that the authors have raised this concern so that researchers can in due course take a look at the fertility of those who were infected by COVID-19.'

Those who have tested positive for the coronavirus and concerned about their fertility should discuss this with their family doctor, Professor Pacey suggested. Men can have a 'relatively simple' semen analysis three months after infection.

The tests may be more valuable for experts looking at the potential link between coronavirus and male fertility on a population-wide scale.

'The problem in interpreting the results from semen analysis is that for most men who are infected with COVID-19, they wouldn't have had their fertility tested beforehand, so it is going to be very difficult with an individual man to know if any abnormal test result was due to the virus or not,' he said. 'However, across a large population of men (several hundred), it should be possible to see if rates of poor sperm quality are higher than what might be predicted.'