{"id":476,"title":"COVID-19 and male infertility - A review","title_zh":"COVID-19 与男性不育：一项系统综述","url":"https://doi.org/10.21203/rs.3.rs-11538306/v1","doi":"10.21203/rs.3.rs-11538306/v1","pmid":null,"journal":"Research Square","kind":"preprint","lang":"en","published_at":"2026-10-29T00:00:00+00:00","fetched_at":"2026-11-08T03:44:14+00:00","authors":["Suresh R","Kumar R"],"primary_topic":"male","topics":[{"slug":"male","score":10.0,"hits":["male infertility","semen","seminal","sperm","sperm dna","spermatogenesis","spermatozoa","testicular"]},{"slug":"art-clinical","score":5.0,"hits":["gonadotrophin","infertility"]}],"topic_score":10.0,"preference_score":0.0,"preference_labels":[],"llm_score":55.0,"final_score":55.0,"score_dims":{"novelty":33,"rigor":56,"impact":45,"relevance":74,"translation":58},"recommend_reason":"选题属男性生殖核心范畴且结论对临床咨询（感染后精液异常的处理与复查时机）有直接提示，但该主题已有大量综述与原始研究，本文为定性整合、无新数据与新机制，且为未经同行评议的预印本，适合快速浏览而非必读。","keywords":["COVID-19","男性不育","精液参数","精子DNA碎片化","氧化应激","系统综述"],"selected":0,"story_id":280,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"europepmc-preprints","source_name":"Europe PMC · 预印本（领域内）","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":"research-square","journal_tier":"standard","journal_if":null,"is_mock":false,"summary_zh":"该预印本系统综述汇总了确诊或既往 SARS-CoV-2 感染男性的已发表人体研究，评估感染与精液常规参数、精子 DNA 碎片化与氧化应激、生殖激素、精液中病毒检测及恢复时程的关联；结果按 PRISMA 2020 原则做定性整合，未进行定量合并。结果提示：感染后短期内精子浓度、总数与活力下降，精子 DNA 碎片化及精液氧化/炎症标志物可能升高，症状期可见睾酮一过性降低或促性腺激素关系改变；精液中 SARS-CoV-2 RNA 罕有检出。多数纵向研究显示数月内改善。作者认为 COVID-19 多为暂时性生殖应激，机制以发热、炎症、氧化应激与内分泌扰动等间接途径为主，证据不足以认定其常导致永久不育，建议异常者约一个生精周期后复查。","summary":"Abstract Background: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a systemic illness capable of influencing the male reproductive system through fever, inflammation, oxidative stress, vascular injury and endocrine disturbance. Because spermatogenesis is temperature-sensitive and spermatozoa are vulnerable to oxidative damage, semen quality may be altered during acute infection and early recovery. Objective: This systematic review evaluates the association between COVID-19 and male reproductive function, with a focus on conventional semen parameters, sperm DNA fragmentation and oxidative stress, reproductive hormones, SARS-CoV-2 detection in semen, and the time course of recovery. Methods: Published human studies of confirmed or previous SARS-CoV-2 infection were identified through structured searches of electronic literature sources. Eligible observational studies reported at least one male reproductive outcome, including semen quality, sperm functional integrity, reproductive hormones, or viral detection in semen/testicular material. Findings were synthesised qualitatively in accordance with PRISMA 2020 reporting principles (Page et al., 2021). Results: Across the available evidence, the clearest pattern is a short-term reduction in sperm concentration, total sperm count and motility after infection, although individual studies differ in magnitude and not all report persistent abnormalities. Longitudinal and pre/post-infection studies indicate improvement over subsequent months in many men (Guo et al., 2021; Hu et al., 2022; Zhao et al., 2025). Sperm DNA fragmentation and seminal oxidative/inflammatory markers may also increase after COVID-19 (Hajizadeh Maleki and Tartibian, 2021; Yuan et al., 2025). Endocrine studies report transient reductions in testosterone or altered gonadotrophin relationships, particularly during symptomatic disease (Ma et al., 2021; Majzoub et al., 2024). SARS-CoV-2 RNA is rarely detected in semen; one early study reported positive samples, whereas most subsequent cohorts did not (Li et al., 2020; Pan et al., 2020; Ruan et al., 2021). Conclusion: COVID-19 can act as a temporary reproductive stressor in men, particularly after symptomatic or febrile illness. Current evidence supports predominantly indirect mechanisms such as fever, inflammation, oxidative stress and endocrine disturbance, rather than persistent seminal infection. The evidence is insufficient to conclude that COVID-19 commonly causes permanent infertility. When semen results are abnormal soon after infection, repeat assessment after approximately one spermatogenic cycle may help distinguish transient suppression from persistent dysfunction.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}