https://doi.org/10.4081/aiua.2023.11157
Recovery of sperm quality after COVID‐19 disease in male adults under the influence of a micronutrient combination: A prospective study
Submitted: January 15, 2023
Accepted: January 29, 2023
Published: March 13, 2023
Accepted: January 29, 2023
Abstract Views: 1490
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Objective: This study aims to evaluate the safety and efficacy of a standard micronutrient preparation to improve semen parameters and seminal oxidative stress in adult male subjects after Coronavirus Disease 2019 (COVID-19) disease.
Methods: For this prospective pilot study, 30 males aged 20-50 years who had recently recovered from a symptomatic SARS-CoV-2 infection were recruited from June to October 2021 through a public call for participation. Participants of the study group (n = 30) received two semen analyses according to WHO criteria at an interval of 12 weeks, during which they daily received a micronutrient preparation (L-carnitine, L-arginine, coenzyme Q10, vitamin E, zinc, folic acid, glutathione and selenium). Changes in major semen variables and seminal oxidative stress levels before and after therapy were analyzed and compared to a control group (n = 10) adhering to the same inclusion criteria, including subjects who recently recovered from symptomatic COVID-19 disease without micronutrient supplementation within the 12 weeks between the two semen analyses.
Results: After 3 months of micronutrient supplementation the rate of normal semen analysis results in the study group increased significantly (p = 0.009) by 66.7%: from 50.0% before to 83.3% after therapy. There was a significant increase in progressive (p = 0.014) and overall motility (p = 0.05) as well as in the vitality (p = 0.0004) of semen cells after 12 weeks of micronutrient intake. In the control group there were no significant changes in any semen parameter or in the rate of normal semen analysis results over the 3-month observation period. In both groups, sperm density, morphology and oxidative stress did not improve significantly.
Conclusions: Our data suggests that supplementation of certain micronutrients may be a safe way to support recovery of impaired semen parameters in male adults recovered from COVID-19 disease.
WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2022 Dec 31]. Available from: https://covid19.who.int/
Sengupta P, Dutta S, Krajewska-Kulak E. The Disappearing Sperms: Analysis of Reports Published Between 1980 and 2015. Am J Mens Health. 2017; 11:1279-304.
DOI: https://doi.org/10.1177/1557988316643383
Duffy JMN, Adamson GD, Benson E, et al. Top 10 priorities for future infertility research: an international consensus development study. Fertil Steril. 2021; 115:180-90.
DOI: https://doi.org/10.1016/j.fertnstert.2020.11.014
ESHRE, Fertility Europe. A policy audit on fertility. Analysis of 9 EU Countries [Internet]. 2017. Available from: https://fertilityeurope.eu/our-projects/policy-audit/aw12BQtmEbbfXAq-79y0ZmTR
He Y, Wang J, Ren J, et al. Effect of COVID-19 on Male Reproductive System - A Systematic Review. Front Endocrinol 2021; 12:677701.
DOI: https://doi.org/10.3389/fendo.2021.677701
Tiwari S, Kc N, Thapa S, et al. Semen parameters in men recovered from COVID-19: a systematic review and meta-analysis. Middle East Fertil Soc J. 2021; 26:44.
DOI: https://doi.org/10.1186/s43043-021-00089-w
Xie Y, Mirzaei M, Kahrizi MS, et al. SARS-CoV-2 effects on sperm parameters: a meta-analysis study. J Assist Reprod Genet. 2022;39:1555-63.
DOI: https://doi.org/10.1007/s10815-022-02540-x
Dutta S, Sengupta P. SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology. Reprod Sci. 2021; 28:23-6.
DOI: https://doi.org/10.1007/s43032-020-00261-z
Delle Fave RF, Polisini G, Giglioni G, et al. COVID-19 and male fertility: Taking stock of one year after the outbreak began. Arch Ital Urol Androl. 2021; 93:115-9.
DOI: https://doi.org/10.4081/aiua.2021.1.115
Haghpanah A, Masjedi F, Alborzi S, et al. Potential mechanisms of SARS-CoV-2 action on male gonadal function and fertility: Current status and future prospects. Andrologia. 2021; 53:e13883.
DOI: https://doi.org/10.1111/and.13883
Agarwal A, Panner Selvam MK, Arafa M, et al. Multi-center evaluation of oxidation-reduction potential by the MiOXSYS in males with abnormal semen. Asian J Androl. 2019; 21:565-9.
DOI: https://doi.org/10.4103/aja.aja_5_19
Alahmar AT. Role of Oxidative Stress in Male Infertility: An Updated Review. J Hum Reprod Sci. 2019; 12:4-18.
DOI: https://doi.org/10.4103/jhrs.JHRS_150_18
Panner Selvam MK, Agarwal A, Henkel R, et al. The effect of
Buhling K, Schumacher A, Eulenburg CZ, Laakmann E. Influence of oral vitamin and mineral supplementation on male infertility: a meta-analysis and systematic review. Reprod Biomed Online. 2019;39:269-79.
DOI: https://doi.org/10.1016/j.rbmo.2019.03.099
Salas-Huetos A, Rosique-Esteban N, Becerra-Tomás N, et al. The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Adv Nutr. 2018; 9:833-48.
DOI: https://doi.org/10.1093/advances/nmy057
Choy JT, Eisenberg ML. Male infertility as a window to health. Fertil Steril. 2018; 110:810-4.
DOI: https://doi.org/10.1016/j.fertnstert.2018.08.015
World Health Organization. WHO laboratory manual for the examination and processing of human semen [Internet]. 6th ed. Geneva: World Health Organization; 2021 [cited 2022 Oct 5]. Available from: https://apps.who.int/iris/handle/10665/343208
Imhof M, Lackner J, Lipovac M, et al. Improvement of sperm
World Health Organization, editor. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World Health Organization; 2010. p. 271
Agarwal A, Bui AD. Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility. Investig Clin Urol. 2017; 58:385-99.
DOI: https://doi.org/10.4111/icu.2017.58.6.385
Chen JM. Novel statistics predict the COVID-19 pandemic could terminate in 2022. J Med Virol. 2022; 94:2845-8.
DOI: https://doi.org/10.1002/jmv.27661
trient supplementation on spermatozoa DNA integrity in subfertile
Daria S, Islam MR. The SARS-CoV-2 omicron wave is indicating the end of the pandemic phase but the COVID-19 will continue. J Med Virol. 2022; 94:2343-5
DOI: https://doi.org/10.1002/jmv.27635
Donders GGG, Bosmans E, Reumers J, et al. Sperm quality and absence of SARS-CoV-2 RNA in semen after COVID-19 infection: a prospective, observational study and validation of the SpermCOVID test. Fertil Steril. 2022; 117:287-96
DOI: https://doi.org/10.1016/j.fertnstert.2021.10.022
Brodin P. Immune determinants of COVID-19 disease presentation and severity. Nat Med. 2021;27:28-33.
DOI: https://doi.org/10.1038/s41591-020-01202-8
Hu B, Liu K, Ruan Y, et al. Evaluation of mid- and long-term impact of COVID-19 on male fertility through evaluating semen parameters. Transl Androl Urol. 2022;11:159-67.
DOI: https://doi.org/10.21037/tau-21-922
Sheikhzadeh Hesari F, Hosseinzadeh SS, Asl Monadi Sardroud MA. Review of COVID-19 and male genital tract. Andrologia. 2021;53:e13914.
DOI: https://doi.org/10.1111/and.13914
Patel DP, Punjani N, Guo J, et al. The impact of SARS-CoV-2 and COVID-19 on male reproduction and men’s health. Fertil Steril. 2021;115:813-23.
DOI: https://doi.org/10.1016/j.fertnstert.2020.12.033
Huang C, Ji X, Zhou W, Huang Z, et al. Coronavirus: A possible cause of reduced male fertility. Andrology. 2021; 9:80-7.
DOI: https://doi.org/10.1111/andr.12907
Agarwal A, Rana M, Qiu E, et al. Role of oxidative stress, infection and inflammation in male infertility. Andrologia. 2018; 50:e13126.
DOI: https://doi.org/10.1111/and.13126
Sengupta P, Leisegang K, Agarwal A. The impact of COVID-19 on the male reproductive tract and fertility: A systematic review. Arab J Urol. 2021; 19:423-36.
DOI: https://doi.org/10.1080/2090598X.2021.1955554
Hajizadeh Maleki B, Tartibian B. COVID-19 and male reproductive function: a prospective, longitudinal cohort study. Reproduction. 2021; 161:319-31.
DOI: https://doi.org/10.1530/REP-20-0382
Falahieh FM, Zarabadipour M, Mirani M, et al. Effects of moderate COVID-19 infection on semen oxidative status and parameters 14 and 120 days after diagnosis. Reprod Fertil Dev. 2021; 33:683-90.
DOI: https://doi.org/10.1071/RD21153
Shcherbitskaia AD, Komarova EM, Milyutina YP, et al. Oxidative Stress in Male Infertility: An
Oxidative Stress Markers and Sperm DNA Fragmentation in Men Recovered from COVID-19. Int J Mol Sci. 2022; 23:10060.
DOI: https://doi.org/10.3390/ijms231710060
Panner Selvam MK, Agarwal A, Henkel R, et al. The effect of oxidative and reductive stress on semen parameters and functions of Influence of physiologically normal human spermatozoa. Free Radic Biol Med. 2020; 152:375-85.
DOI: https://doi.org/10.1016/j.freeradbiomed.2020.03.008
Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019; 72:579-87.
DOI: https://doi.org/10.1136/jclinpath-2018-205579
Leisegang K, Sengupta P, Agarwal A, Henkel R. Obesity and male infertility: Mechanisms and management. Andrologia. 2021;53:e13617.
DOI: https://doi.org/10.1111/and.13617
Rafiee B, Bagher Tabei SM. The effect of N-acetyl cysteine consumption on men with abnormal sperm parameters due to positive history of COVID-19 in the last three months. Arch Ital Urol Androl. 2021; 93:465-7.
DOI: https://doi.org/10.4081/aiua.2021.4.465
Imhof M, Lackner J, Lipovac M, et al. Improvement of sperm quality after micronutrient supplementation. e-SPEN Journal. 2012;7:e50-3.
DOI: https://doi.org/10.1016/j.eclnm.2011.11.002
Tsounapi P, Honda M, Dimitriadis F, et al. Effects of a micronutrient supplementation combined with a phosphodiesterase type 5 inhibitor on sperm quantitative and qualitative parameters, percentage of mature spermatozoa and sperm capacity to undergo hyperactivation: A randomised controlled trial. Andrologia. 2018; 50:e13071.
DOI: https://doi.org/10.1111/and.13071
Lipovac M, Nairz V, Aschauer J, Riedl C. The effect of micronutrient supplementation on spermatozoa DNA integrity in subfertile men and subsequent pregnancy rate. Gynecological Endocrinology. 2021; 37:711-5.
DOI: https://doi.org/10.1080/09513590.2021.1923688
Smits RM, Mackenzie-Proctor R, Yazdani A, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2019;3:CD007411.
DOI: https://doi.org/10.1002/14651858.CD007411.pub4
Vishvkarma R, Alahmar AT, Gupta G, Rajender S. Coenzyme Q10 effect on semen parameters: Profound or meagre? Andrologia [Internet]. 2020 Jul [cited 2023 Jan 2]; 52(6). Available from: https://onlinelibrary.wiley.com/doi/10.1111/and.13570
DOI: https://doi.org/10.1111/and.13570
Ebisch IMW, Thomas CMG, Peters WHM, et al. The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility. Hum Reprod Update. 2007; 13:163-74.
DOI: https://doi.org/10.1093/humupd/dml054
CoVariants Website: Overview of SARS-CoV-2 Variants in Countries over Time. [cited 2023 Jan 5]. Available from: https://covariants.org/per-country.
How to Cite
Aschauer, J., Sima, M., & Imhof, M. (2023). Recovery of sperm quality after COVID‐19 disease in male adults under the influence of a micronutrient combination: A prospective study. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11157
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