The researchers determined that SARS-CoV-2 it causes the changes employment semen quality of patients who have contracted Covid-19. They also found that the virus, too Affects the testicles, which impairs the ability of the male gonads Sperm production and hormones.
According to Agência FAPESP, upon monitoring, since the beginning of last year, Male patients who have contracted Covid-19Andrologist Jorge Hallak, professor at the University of São Paulo School of Medicine (FM-USP) and coordinator of the study group on men’s health at the Institute for Advanced Study (IEA-USP), is starting to notice that Fertility test results and their hormonal change same After months of recovering from illness.
Despite being a preliminary test and not being able to diagnose fertility or sterility, the spermograms of many patients, for example, indicated that Sperm motility and fertilization The egg – whose normal rate is above 50% – Fell between 8% and 12% and remained at that level for about a year after being infected with SARS-CoV-2. Hormonal tests indicate this Testosterone levels Lots of them too I retreated after illness. While the normal level of this hormone is 300 to 500 nanograms per deciliter of blood (ng/dL), in patients who have been infected with the Covid-19 virus, this indicator ranged from 200 and often remained between 70 and 80 ng/dL.
“It is very worrying how the new coronavirus affects the testicles, even in cases of asymptomatic or mild disease. Of all the factors harmful to the testicles I have studied so far, SARS-CoV-2 appears to be very active. Each pathology has its own Its properties are shown to us by practice and experience. SARS-CoV-2 has the characteristic of affecting spermatogenesis. We are exploring the mechanisms involved, such as constantly very low progressive motility and well-changing morphology, with no significant change in sperm concentration,” as barber says.
In a study of 26 patients with Covid-19, researchers investigated this Ultrasound examinations That more than half of them have EpididymitisIt is the structure responsible for storing sperm and in which it acquires the ability to move.
patients have Average age 33 years He attended Hospital das Clinicas at FM-USP and at the Androscience Institute for Science and Innovation in Andrology. You are Results Act study It was published in the magazine masculinity.
“Unlike traditional bacterial infections or other viruses, such as mumps, which cause swelling, discomfort or pain in the testicles in a third of those infected, epididymitis caused by the new coronavirus is painless and cannot be diagnosed by touch. [exame físico] Or with the naked eye, explains Hallaq.
Therefore, according to him, it will be interesting to teach Testicular self-examination As a post-pandemic public health policy.
“It is ideal that adolescents, young adults, and men of age or desire to have children, after infection with SARS-CoV-2, seek out a urologist or andrologist and make an appointment with a testicular volume measurement and measurement of testosterone and other hormones, as well as an analysis of Semen with sperm function tests, followed by an ultrasound scan using a color Doppler, to check for any type of testicular involvement that could affect fertility and hormone production, suggests Barber.
He notes that “these individuals should be followed up for one to two years after infection, at least, because we still do not know how the disease progresses.”
testicular cells
else study Recently published by the same group of researchers indicated that SARS-CoV-2 invades all types of testicular cells, causing injuries can hurt Hormonal function and male fertility.
Through a project coordinated by FM-USP Professors Paolo Saldiva and Marisa Dolnikov, minimally invasive autopsy techniques were used to Extraction of samples of testicular tissue of 11 men with Between 32 and 88 years old, who died at HC-FM-USP due to severe Covid-19.
The results of the analysis indicated Testicular injury series Which can be attributed to inflammatory changes that reduce sperm production (spermatogenesis) and hormones.
“What immediately caught our attention in these patients who died of COVID-19 was the sharp decrease in spermatogenesis. Even the youngest of them, of reproductive age, have practically no sperm,”
Amaro Nunes Duarte Neto, an infectious disease specialist and pathologist at FM-USP and the Adolfo Lutz Institute and study coordinator, tells SELF.
According to the researcher, some of the possible causes of low spermatogenesis in these patients were: virus infections In the vessels of the parenchyma of the testicle, with the presence of thrombi, resulting in hypoxia – tissue hypoxia – as well as fibrosis blocking the seminiferous tubules in which spermatozoa are produced.
One possible cause of low hormones is Leydig cell loss, which are located between the seminiferous tubules and Testosterone production.
The functions of the testicles to produce sperm and male sex hormones are independent, but there is an interrelationship between them. “If hormone production is hampered by Leydig cells, fertility will decrease as well,” says Duarte Neto.
Some symptoms of low testosterone (hypogonadism) are: Muscle loss, fatigue, irritability, memory loss and weight gain, which can be confused with the long-term effects of Covid-19.
An important part of this clinical picture is certainly related to reduced testicular function. But this has not yet been dealt with because patients are not in pain and it is not usual to measure hormones or analyze sperm after they have recovered from Covid-19,” warns Hallaq.
male infertility
Researcher estimates that Covid-19 can cause a Increased male infertility. Currently, between 15% and 18% of couples have difficulties conceiving – due to male problems in 52% of cases.
This scenario can trigger a file More research on assisted reproductive technologies Which, he says, is sometimes done urgently in Brazil for male reasons, without an adequate and standardized initial evaluation and often without establishing the initial causative diagnosis and without enough time to suggest approaches based on best cost-effectiveness and application of specific treatments that can treat the cause or Restores a The ability to natural fertility.
Another concern for the researcher is testosterone replacement in those patients with disease and low hormones, which, he says, is an unnecessary procedure in the immediate post-Covid-19 period, especially for young adults and of reproductive age.
“Replacing testosterone in an already affected patient will suppress testicular function further. The testes have repair mechanisms to produce hormones again, and there are drug treatments that increase the natural production of steroid hormones, gradually restoring the individual’s intrinsic testicular function. This will also depend on whether the Leydig cells She might have been injured and to what degree, something we don’t know yet,” he wonders.
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