Male infertility and COVID-19: Is there a relationship?




COVID-19; COVID-19 Virus Disease; COVID-19 Virus Infection; SARS-CoV-2; Male Infertility; Reproductive health.


In the testicles, the expression of Angiotensin-Converting Enzyme 2 receptors makes it more susceptible to infection by Sars-CoV-2 and, therefore, to male infertility with significant health problems for the patient. Therefore, this study aimed to analyze the clinical pathophysiology and the mechanisms involved in the genesis of male infertility from COVID-19, through the critical analysis of the main scientific evidence on the subject presented so far. From an integrative review of the literature containing 30 studies selected using inclusion criteria in the period 2020-2021, the direct and indirect impacts on male fertility in pathophysiological and psychosocial terms were observed in this study, in addition to therapeutic options, guidelines host and efficient semiological approach. Thus, the impact of the pandemic, even after one year, is immeasurable. Additional studies to reveal the real consequences and the mechanism by which the disease can affect male fertility are still needed. It is essential to pay more attention to male genital exams in patients with COVID-19. The psychobiological consequences of the pandemic in infertile patients should not be underestimated.


Bahadur, G., Acharya, S., Muneer, A., Huirne, J., Łukaszuk, M., Doreski, P. A., & Homburg, R. (2020). SARS-CoV-2: diagnostic and design conundrums in the context of male factor infertility. Reproductive biomedicine online, 41(3), 365–369.

Batiha, O., Al-Deeb, T., Al-Zoubi, E., & Alsharu, E. (2020). Impact of COVID-19 and other viruses on reproductive health. Andrologia, 52(9), e13791.

Bocchese, N. V., Dávila, N. G., Rodrigues, M. B. M., Araújo-Neto, I., Costa, M. O., Barbalho, D. M. G., Rêgo, A. C. M., & Araújo-Filho, I. (2020). COVID-19 and Liver Injury: Hepatology Perspectives. Journal of Clinical Gastroenterology and Treatment, 6(074), 1-5.

Bocchese, N. V., Dávila, N. G., Rodrigues, M. B. M., Monte, R. R. L., Melo, R. C., Rêgo, A. C. M., & Araújo-Filho, I. (2020). Covid-19: Gastroenterology Perspectives. Journal of clinical gastroenterology and treatment, 6(075), 1-8.

Dantas, T. C; Gomes, A. C. A.; Lima, I. P. C; Lucas, B. B; Aguiar, M. R; Cavalcanti, T. C; Pinheiro, F. I. .; Rêgo, A. C. M; Araújo-filho,, I. Corticosteroid therapy in patients with severe COVID-19. Research, Society and Development, [S. l.], v. 10, n. 1, p. e58910112114, 2021. DOI: 10.33448/rsd-v10i1.12114. Disponível em: Acesso em: 11 may. 2021.

Dutta, S., & Sengupta, P. (2021). SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology. Reproductive sciences (Thousand Oaks, Calif.), 28(1), 23–26.

Efremov, E. A., Kasatonova, E. V., Melnik, Y. I., & Nikushina, A. A. (2020). Urologiia (Moscow, Russia : 1999), (4), 104–110. PMID: 32897023.

Esposito, V., Rania, E., Lico, D., Pedri, S., Fiorenza, A., Strati, M. F., Conforti, A., Marrone, V., Carosso, A., Revelli, A., Zullo, F., Di Carlo, C., & Venturella, R. (2020). Influence of COVID-19 pandemic on the psychological status of infertile couples. European journal of obstetrics, gynecology, and reproductive biology, 253, 148–153.

Fu, J., Zhou, B., Zhang, L., Balaji, K. S., Wei, C., Liu, X., Chen, H., Peng, J., & Fu, J. (2020). Expressions and significances of the angiotensin-converting enzyme 2 gene, the receptor of SARS-CoV-2 for COVID-19. Molecular biology reports, 47(6), 4383–4392.

Goés, A. B. M., Cardoso, B. B., Tavares, F. A. F., Monte, R. R. L., Melo, R. C., Araújo-Neto, I., Pinheiro, R. S. E., Rêgo, A. C. M., & Araújo-Filho, I. (2020). COVID-19 and Nervous System: Under Estimated Clinical and Prognostic Aspects. International journal of neurology and neurotherapy, 7(100), 1-7.

Haghpanah, A., Masjedi, F., Alborzi, S., Hosseinpour, A., Dehghani, A., Malekmakan, L., & Roozbeh, J. (2021). Potential mechanisms of SARS-CoV-2 action on male gonadal function and fertility: Current status and future prospects. Andrologia, 53(1), e13883.

Hallak, J., & Esteves, S. C. (2020). Concise practice recommendations for the provision of andrological services and assisted reproductive technology for male infertility patients during the SARS-CoV-2 in Brazil. International braz j urol : official journal of the Brazilian Society of Urology, 46(6), 1082–1089.

Holtmann, N., Edimiris, P., Andree, M., Doehmen, C., Baston-Buest, D., Adams, O., Kruessel, J. S., & Bielfeld, A. P. (2020). Assessment of SARS-CoV-2 in human semen-a cohort study. Fertility and sterility, 114(2), 233–238.

Illiano, E., Trama, F., & Costantini, E. (2020). Could COVID-19 have an impact on male fertility?. Andrologia, 52(6), e13654.

Li, R., Yin, T., Fang, F., Li, Q., Chen, J., Wang, Y., Hao, Y., Wu, G., Duan, P., Wang, Y., Cheng, D., Zhou, Q., Zafar, M. I., Xiong, C., Li, H., Yang, J., Qiao, J.. Potential risks of SARS-CoV-2 infection on reproductive health. Reprod Biomed Online. 2020 Jul;41(1):89-95. doi: 10.1016/j.rbmo.2020.04.018.

Li, X. P., Zhang, Y. D., Xia, K., Liu, G. H., & Deng, C. H. (2020). Zhonghua nan ke xue = National journal of andrology, 26(3), 215–218. PMID: 33346959.

Liu, X., Chen, Y., Tang, W., Zhang, L., Chen, W., Yan, Z., Yuan, P., Yang, M., Kong, S., Yan, L., & Qiao, J. (2020). Single-cell transcriptome analysis of the novel coronavirus (SARS-CoV-2) associated gene ACE2 expression in normal and non-obstructive azoospermia (NOA) human male testes. Science China. Life sciences, 63(7), 1006–1015.

Monte, R. R. L., Tavares, F. A. F., Cardoso, B. B., Goes, A. B. M., Silva, T. C. L., Silva, B. O., Araújo, Y. S. M., Rêgo, A. C. M., & Araújo-Filho, I. (2020). Covid-19 Pandemic and Health Professionals: Practical Approaches. International Journal of Critical Care and Emergency Medicine, 6(108), 1-9.

Olaniyan, O. T., Dare, A., Okotie, G. E., Adetunji, C. O., Ibitoye, B. O., Bamidele, O. J., & Eweoya, O. O. (2020). Testis and blood-testis barrier in Covid-19 infestation: role of angiotensin-converting enzyme 2 in male infertility. Journal of basic and clinical physiology and pharmacology, 31(6).

Pacchiarotti, A., Frati, G., & Saccucci, P. (2020). A surprising link with unexplained infertility: a possible Covid-19 paradox?. Journal of assisted reproduction and genetics, 37(11), 2661–2662.

Pan, F., Xiao, X., Guo, J., Song, Y., Li, H., Patel, D. P., Spivak, A. M., Alukal, J. P., Zhang, X., Xiong, C., Li, P. S., & Hotaling, J. M. (2020). No evidence of severe acute respiratory syndrome-coronavirus 2 in semen of males recovering from coronavirus disease 2019. Fertility and sterility, 113(6), 1135–1139.

Renu, K., Subramaniam, M. D., Chakraborty, R., Myakala, H., Iyer, M., Bharathi, G., Siva, K., Vellingiri, B., & Valsala Gopalakrishnan, A. (2020). The role of Interleukin-4 in COVID-19 associated male infertility - A hypothesis. Journal of reproductive immunology, 142, 103213.

Segars, J., Katler, Q., McQueen, D. B., Kotlyar, A., Glenn, T., Knight, Z., Feinberg, E. C., Taylor, H. S., Toner, J. P., Kawwass, J. F., & American Society for Reproductive Medicine Coronavirus/COVID-19 Task Force (2020). Prior and novel coronaviruses, Coronavirus Disease 2019 (COVID-19), and human reproduction: what is known?. Fertility and sterility, 113(6), 1140–1149.

Selvaraj, K., Ravichandran, S., Krishnan, S., Radhakrishnan, R. K., Manickam, N., & Kandasamy, M. (2021). Testicular Atrophy and Hypothalamic Pathology in COVID-19: Possibility of the Incidence of Male Infertility and HPG Axis Abnormalities. Reproductive sciences (Thousand Oaks, Calif.), 1–8. Advance online publication.

Sheikhzadeh Hesari, F., Hosseinzadeh, S. S., & Asl Monadi Sardroud, M. A. (2021). Review of COVID-19 and male genital tract. Andrologia, 53(1), e13914.

Shen, Q., Xiao, X., Aierken, A., Yue, W., Wu, X., Liao, M., & Hua, J. (2020). The ACE2 expression in Sertoli cells and germ cells may cause male reproductive disorder after SARS-CoV-2 infection. Journal of cellular and molecular medicine, 24(16), 9472–9477.

Tian, Y., & Zhou, L. Q. (2021). Evaluating the impact of COVID-19 on male reproduction. Reproduction (Cambridge, England), 161(2), R37–R44.

Trinchant, R. M., Cruz, M., Marqueta, J., & Requena, A. (2020). Infertility and reproductive rights after the COVID-19 pandemic. Reproductive biomedicine online, 41(2), 151–153.

Vishvkarma, R., & Rajender, S. (2020). Could SARS-CoV-2 affect male fertility?. Andrologia, 52(9), e13712.

Younis, J. S., Abassi, Z., & Skorecki, K. (2020). Is there an impact of the COVID-19 pandemic on male fertility? The ACE2 connection. American journal of physiology. Endocrinology and metabolism, 318(6), E878–E880.




How to Cite

GOÉS, A. B. M. de .; ARAÚJO-NETO, I. .; ARAÚJO, N. M. .; VILLARIM, P. V. de O. .; SILVA, T. C. L. da .; VILLARIM, C. V. de O. .; RÊGO, A. C. M. .; ARAÚJO-FILHO, I. Male infertility and COVID-19: Is there a relationship?. Research, Society and Development, [S. l.], v. 10, n. 6, p. e46510616059, 2021. DOI: 10.33448/rsd-v10i6.16059. Disponível em: Acesso em: 23 jun. 2021.



Review Article