Sir,
We would like to congratulate you for the original research recently published in QJM entitled ‘Post-Covid-19 associated decline in long-term male fertility and embryo quality during assisted reproductive technology (ART)’.1 The authors showed a major alteration in sperm parameters and sperm DNA damage in a man tested positive for COVID-19; this had an impact on post-ART embryo morphology. The authors suggested that these signs were specifically due to COVID-19.
Fever is a symptom observed in more than 80% of patients with COVID-19. Indeed, the physiological mechanisms of thermal regulation of the scrotum are exceeded when the body temperature rises by even one degree Celsius. Thus, fever, even of limited duration, can, on its own, induce sperm parameters major alteration, sperm DNA damage, sperm apoptosis and germ cell death as previously described.2,3 The return of sperm parameters to basal state can take a long time, more than 3 or 4 months.4,5 For this reason, it has been recommended from the onset of the pandemic to delay ART management for at least 3 months in men diagnosed with COVID-19.6 In the absence of fever, the effects of the new coronavirus and COVID-19 on sperm parameters and male fertility remain unclear.
Conflict of interest. None declared.
References
- 1. Mannur S, Jabeen T, Khader MA, Rao LSS. Post-COVID-19 associated decline in long-term male fertility and embryo quality during assisted reproductive technology. Q J Med 2021; doi: 10.1093/qjmed/hcab019. [DOI] [PMC free article] [PubMed]
- 2. Sergerie M, Mieusset R, Croute F, Daudin M, Bujan L. High risk of temporary alteration of semen parameters after recent acute febrile illness. Fertil Steril 2007; 88:970e1–7. [DOI] [PubMed] [Google Scholar]
- 3. Durairajanayagam D, Agarwal A, Ong C. Causes, effects and molecular mechanisms of testicular heat stress. Reprod Biomed Online 2015; 30:14–27. [DOI] [PubMed] [Google Scholar]
- 4. Carlsen E, Andersson AM, Petersen JH, Skakkebaek NE. History of febrile illness and variation in semen quality. Hum Reprod 2003; 18:2089–92. [DOI] [PubMed] [Google Scholar]
- 5. Lazarus BA, Zorgniotti AW. Thermoregulation of the human testis. Fertil Steril 1975; 26:757–9. [PubMed] [Google Scholar]
- 6. Hamdi S, Bendayan M, Huyghe E, Soufir JC, Amar E, El OR, et al. COVID-19 and andrology: recommendations of the French-speaking society of andrology (Société d'Andrologie de langue Française SALF). Basic Clin Androl 2020; 30. [DOI] [PMC free article] [PubMed] [Google Scholar]