Doctors in central Wuhan are planning to conduct a long-term study of the effects of COVID-19 on the male reproductive system after a small study of 81 men revealed that coronavirus patients haed roughly half the normal ratio of testosterone after contracting the disease, according to SCMP.

Though still preliminary and not peer reviewed, the study is the first clinical observation of the potential impact of Covid-19, the disease caused by the coronavirus, on the male reproductive system, especially among younger groups.

In a paper published on the preprint research platform  medRxiv.org, the researchers – from Zhongnan Hospital of Wuhan University and the Hubei Clinical Research Centre for Prenatal Diagnosis and Birth Health – said they analysed blood samples from 81 men aged 20 to 54 who tested positive for the coronavirus and were hospitalised in January.


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The median age of the participants was 38 and roughly 90 per cent of them had only mild symptoms. The samples were collected in the last days of their stay in hospital. –SCMP

Previous studies have shown that coronavirus binds with the protein receptor cell, ACE2, a large number of which are found in the testicles.

Researchers looked at the ratio of testosterone to luteinising hormone (T/LH) – finding that the average ratio for COVID-19 patients was 0.74, around half the normal level. A low T/LH ratio can signal hypogonadism – a malfunction of the testicles which could lead to lower production of the sex hormone.

Testosterone is the main male sex hormone critical for the development of primary and secondary sexual characteristics including testes, muscle, bone mass and body hair. Luteinising hormone is found in both men and women, and best known for its ability to trigger ovulation. –SCMP

Those with hypogonadism can develop large breasts and erectile dysfunction – a condition which can be cured with testosterone treatment.

“Since more than half of the people with Covid-19 were reproductive-aged, more attention should be paid to the effect of Sars-CoV-2 on the reproductive system,” the Wuhan researchers wrote – noting that their results were inconclusive and that other factors such as medication and immune system response could also trigger changes in hormones.

As such, the researchers say they plan a long-term study which may include the collection and analysis of sperm samples as well as interviews with coronavirus patients.

Professor of reproductive medicine at Tongji Hospital in Wuhan, Li Yufeng, had predicted in a study that the testicles could become a ‘major target’ in a coronavirus infection.

Other studies have also suggested that severe acute respiratory syndrome, or Sars, a distant relative of the new coronavirus, could also cause inflammation in the testicles.

A researcher with the State Key Laboratory of Reproductive Medicine at Nanjing Medical University, said the new observations were “highly valuable information” but a bigger sample would be needed to clarify the results. –SCMP

Many viruses can affect fertility, but not every virus can cause a pandemic. If the impact is long lasting, it can be a problem,” said the researcher – speaking on condition of anonymity.

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