SARS-CoV-2, fertility-related autoantibodies and reproductive injury

Arad Dotan, Darja Kanduc, Sylviane Muller, Yehuda Shoenfeld

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


As the critical risk of the short-term SARS-CoV-2 infection is severe lung inflammation with a hypercoagulative state that could escalate to multiorgan failure, many possible long-term implications are still under investigation. This article will review the most recent findings related to the potential contribution of SARS-CoV-2 to male infertility. Viral-induced male infertility has been studied widely and in much detail in the past. Numerous viral infections have a well-known ability to induce orchitis, resulting in impaired testicular functions and male infertility. SARS-CoV-2 may be an additional virus that is related to male infertility for several reasons that will be dealt with in this review: [1] the strong affinity of SARS-CoV-2 for the human ACE2 receptor, [2] SARS-CoV-2 induced sex steroid hormonal abnormalities, [3] increased levels of oxidative stress in COVID-19, and [4] molecular mimicry between humans and components of SARS-CoV-2 leading to antigenic cross-reactivity phenomena. As these mechanisms might be responsible for SARS-CoV-2-induced male infertility, new evidence demonstrates testicular damage and semen abnormalities following the viral infection. Pathological findings of patients who died of COVID-19 exhibit injury to Sertoli cells and seminiferous tubules with a reduction in Leydig cells, which all are critical components of spermatogenesis. Moreover, impairment of sperm quality was found in SARS-CoV-2-infected patients. Those manifestations found in COVID-19-ill patients, parallel to sex steroid hormonal abnormalities, might critically influence spermatogenesis and SARS-CoV-2-induced male infertility.

Original languageEnglish
Title of host publicationAutoimmunity, COVID-19, Post-COVID19 Syndrome and COVID-19 Vaccination
Number of pages7
ISBN (Electronic)9780443185663
ISBN (Print)9780443185670
StatePublished - 1 Jan 2022


  • ACE-2
  • Anti-TPO
  • Autoantibodies
  • COVID-19
  • Fertility
  • Hormonal abnormalities
  • Male infertility
  • Molecular mimicry
  • Oxidative stress
  • SARS-CoV-2
  • Spermatogenesis


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