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Será que existe associação entre a infeção por SARS-COV-2 e a sua vacinação nas caraterísticas do espermograma?
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Introdução e objetivos: A COVID-19 é induzida pelo vírus SARS-CoV-2. Os testículos são um órgão potencialmente afetado pelo vírus porque possuem o recetor ACE2. A influência do SARS-CoV-2 e respetiva vacinação na fertilidade masculina tem vindo a ser discutida de forma controversa nos últimos anos, não existindo dados nacionais. O objetivo deste estudo é avaliar se existe influência da infeção por SARS-CoV-2 e/ou da respetiva vacinação na fertilidade masculina através das características do espermograma.
Material e Métodos: Estudo retrospetivo através da revisão dos espermogramas realizados na Unidade de Medicina Reprodutiva do Hospital de Santa Maria nos anos 2017/18 (pré-pandemia) e 2021/22 (pós-pandemia). O grupo pós-pandemia foi contactado telefonicamente para obter informações sobre a data de infeção e vacinação.
Resultados: Comparando o grupo pré e pós-pandemia, no grupo pós pandemia registámos uma maior duração da infertilidade na altura da colheita do espermograma (p<0,001), uma menor concentração total de espermatozoides (p = 0,02), menor % morfologia normal (p < 0,001) e maior swim up (p = 0,009). Não foram registadas diferenças estatisticamente significativas nas características dos espermogramas entre os homens que reportaram infeção comparativamente com os que não tiveram infeção, nem entre o grupo de vacinados vs não vacinados. Nos vacinados, os que reportaram pelo menos uma toma de vacina antes da colheita do espermograma, registaram maior motilidade total e progressiva comparativamente com o grupo com vacinação após colheita.
Discussão e conclusões: A maior duração da infertilidade dos homens que realizaram a colheita de espermograma no período pós-pandemia pode dever-se a constrangimentos no acesso a cuidados de saúde inerentes à pandemia. As diferenças registadas na qualidade do espermograma no grupo pós-pandemia, não obstante não ter sido possível demonstrar associação direta à infeção, não podemos excluir o impacto de infeções não diagnosticadas/reportadas. Não registámos impacto desfavorável da vacinação nas características do espermograma.
Introduction and objectives: COVID-19 is induced by the SARS-CoV-2 virus. Testicles are an organ potentially affected by the virus because they have the ACE2 receptor. The influence of SARS-CoV-2 and respective vaccination on male fertility has been controversially discussed in recent years, with no national data. The aim of this study is to assess whether there is an influence of SARS-CoV-2 infection and/or the respective vaccination on male fertility through sperm analysis characteristics. Material and Methods: Retrospective study through the analysis of spermograms performed at the Reproductive Medicine Unit of Hospital de Santa Maria in the years 2017/18 (pre-pandemic) and 2021/22 (post-pandemic). The post-pandemic group was contacted by telephone to obtain information about the date of infection and vaccination. Results: Comparing the pre- and post-pandemic groups, in the post-pandemic group we noted a longer duration of infertility at the time of sperm collection (p<0.001), a lower total sperm concentration (p = 0.02), a lower % normal morphology (p < 0.001) and greater swim up (p = 0.009). There were no statistically significant differences in the characteristics of the spermograms between men who reported infection compared to those who did not have infection, nor between the vaccinated vs unvaccinated group. In vaccinated individuals, those who reported at least one vaccine intake before the spermogram collection, registered greater total and progressive motility compared to the group vaccinated after collection. Discussion and conclusions: The longer duration of infertility of men who performed the spermogram collection in the post-pandemic period may be due to constraints in accessing health care inherent to the pandemic. The differences noted in the quality of the spermogram in the post-pandemic group, despite not having been able to demonstrate a direct association with the infection, we cannot exclude the impact of undiagnosed/reported infections. We did not note any unfavorable impact of vaccination on spermogram characteristics.
Introduction and objectives: COVID-19 is induced by the SARS-CoV-2 virus. Testicles are an organ potentially affected by the virus because they have the ACE2 receptor. The influence of SARS-CoV-2 and respective vaccination on male fertility has been controversially discussed in recent years, with no national data. The aim of this study is to assess whether there is an influence of SARS-CoV-2 infection and/or the respective vaccination on male fertility through sperm analysis characteristics. Material and Methods: Retrospective study through the analysis of spermograms performed at the Reproductive Medicine Unit of Hospital de Santa Maria in the years 2017/18 (pre-pandemic) and 2021/22 (post-pandemic). The post-pandemic group was contacted by telephone to obtain information about the date of infection and vaccination. Results: Comparing the pre- and post-pandemic groups, in the post-pandemic group we noted a longer duration of infertility at the time of sperm collection (p<0.001), a lower total sperm concentration (p = 0.02), a lower % normal morphology (p < 0.001) and greater swim up (p = 0.009). There were no statistically significant differences in the characteristics of the spermograms between men who reported infection compared to those who did not have infection, nor between the vaccinated vs unvaccinated group. In vaccinated individuals, those who reported at least one vaccine intake before the spermogram collection, registered greater total and progressive motility compared to the group vaccinated after collection. Discussion and conclusions: The longer duration of infertility of men who performed the spermogram collection in the post-pandemic period may be due to constraints in accessing health care inherent to the pandemic. The differences noted in the quality of the spermogram in the post-pandemic group, despite not having been able to demonstrate a direct association with the infection, we cannot exclude the impact of undiagnosed/reported infections. We did not note any unfavorable impact of vaccination on spermogram characteristics.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
COVID-19 Vacinação Espermograma Fertilidade masculina Medicina reprodutiva