In an article just lately revealed in Frontiers in Endocrinology, scientists cracked the potential for cryopreserving sperm from sufferers with coronavirus illness 2019 (COVID-19). The article additionally proposes some solutions to assist cryobanks to hold out the suitable process to protect the semen of sufferers with COVID-19.
Extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen that causes COVID-19, has been discovered to induce numerous reproductive abnormalities, together with lowered sperm manufacturing and structural alteration in testicular tissues , intercourse hormone issues and poor sperm high quality .
Within the male reproductive system, SARS-CoV-2 can have an effect on the blood-testicular barrier to straight assault germ cells and alter the hypothalamic-pituitary-testicular axis to change intercourse hormone secretion. Moreover, virus-induced oxidative stress, irritation, and infection-related fever can alter the general functioning of the reproductive system.
Concerning the presence of SARS-CoV-2 in semen, most research have reported in a non-affirmative approach. Only some research have detected viral RNA in semen. As a result of overlap of the urinary and distal reproductive tracts in males, viral RNA in semen may probably come up from urinary excretion. Moreover, there’s a lack of proof supporting the presence of SARS-CoV-2 in testicular tissues.
Risk of semen cryopreservation
Through the early part of the COVID-19 pandemic, numerous fertility procedures, together with sperm cryopreservation and in vitro (IVF), have been suspended by many cryobanks and fertility facilities on account of fears of work-related viral unfold amongst employees and sufferers. Nonetheless, for sufferers with most cancers or different vital diseases, sperm cryopreservation is an pressing requirement earlier than the beginning of therapeutic interventions as a result of many therapies may cause momentary or everlasting infertility in male sufferers.
Research have detected greater than 27 viruses in semen, together with human immunodeficiency virus (HIV), Zika, and mumps. Some viruses, such because the Zika virus, may even be detected within the sperm of asymptomatic sufferers for as much as a yr after restoration.
Laboratory personnel working in cryobanks or fertility facilities are at excessive danger of direct viral publicity through the processing of semen samples collected from individuals contaminated with the virus. Moreover, cross-contamination between contaminated and uninfected samples can happen through the cryogenic storage stage, as many viruses can survive for a very long time within the ultra-low temperature of liquid nitrogen. Subsequently, semen samples containing infectious virus must be handled with additional warning to keep away from surprising viral publicity and cross-contamination.
Procedures to comply with throughout cryopreservation of semen from sufferers with COVID-19
Though the chance of SARS-CoV-2 an infection in semen may be very low, precautions ought to nonetheless be taken in cryobanks to keep away from pointless well being dangers. Within the present article, scientists have recommended some precautionary procedures primarily based on skilled opinion accessible within the literature.
Cryobanks planning to retailer sperm from COVID-19 sufferers ought to invite reproductive well being authorities to evaluate laboratory circumstances and services. They have to prepare their employees on correct precautionary procedures and manage a separate laboratory to gather sperm from COVID-19 sufferers.
To reduce direct affected person contact, on-line platforms might be used to gather medical and epidemiological historical past of sufferers with acute SARS-CoV-2 an infection. Semen samples must be examined by reverse transcriptase-polymerase chain response (RT-PCR) to detect SARS-CoV-2. SARS-CoV-2 detrimental samples ought to then be collected in high-security cryogenic vials and saved in vapor part liquid nitrogen.
Given the potential for a chronic presence of SARS-CoV-2 within the physique, recovered COVID-19 sufferers must be supplied with cryopreservation services for no less than three months after the decision of signs. Particularly, this interval must be prolonged 6 months or extra for sufferers with extended COVID-19. In non-emergency circumstances, cryopreservation of sperm from sufferers with reinfection must be postponed.
In laboratories coping with physiological and pathological circumstances of the male reproductive system, a Class II biosafety cupboard must be used for emergency sperm cryopreservation of COVID-19 sufferers with different severe illnesses, resembling most cancers. Instantly after analyzing, processing, and storing the sperm, all tools should be disposed of correctly.
Since SARS-CoV-2 might be current in different tissues, direct freezing of surgically collected sperm must be averted. All sperm samples should be repeatedly washed and examined for SARS-CoV-2 earlier than cryopreservation.
Avoiding the storage of SARS-CoV-2 optimistic sperm is strongly advisable. Nonetheless, in emergency circumstances the place further semen samples should not potential, virus-positive samples must be washed with a double-density gradient adopted by a dip. These procedures assist dilute the virus previous to cryopreservation.