Abstract
BACKGROUND: Since the outbreak of coronavirus disease 2019 (COVID-19), many studies have provided evidence supporting the adverse effects of this condition on the male reproductive system. OBJECTIVE: This study aimed to investigate the acute and chronic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the Omicron variant, on different aspects of male reproductive function. MATERIALS AND METHODS: This case-control study was performed at Ganjavian hospital in Dezful, Iran from July 2022-January 2023. Participants were stratified into COVID(+) (n = 35) and COVID(-) (n = 35) groups. The study evaluated semen parameters, SARS-CoV-2 ribonucleic acid, oxidative stress (OS) markers, and sex hormones. RESULTS: The study revealed significant differences in semen parameters consisting of motility (p < 0.001), progressive motility (p < 0.001), and normal morphology (p = 0.001) between the study groups, as well as within the COVID(+) group comparing the acute and chronic phases. Sperm motility was significantly impaired during the acute phase of COVID-19 but showed improvement in the chronic phase (p < 0.001), indicating the effect may be temporary. Significant differences were also observed in follicle-stimulating hormone, luteinizing hormone, and OS markers (p < 0.001) between the COVID(+) and COVID(-) groups. However, SARS-CoV-2 ribonucleic acid was not detected in any of the semen samples. CONCLUSION: In vaccinated men, acute SARS-CoV-2 Omicron infection impaired semen quality elevated OS, and reduced testosterone. These effects are likely caused by fever and testicular inflammation, which can lead to secondary hypogonadism. Moreover, vaccination could likely improve semen quality, but has no protection against secondary hypogonadism.