Abstract

Background: COVID-19, caused by the SARS-CoV-2 virus, has been associated with damage to multiple organ systems. One of the noteworthy aspects of the virus is its effect on male fertility and the reproductive system. We aimed to overview the involved molecular pathways to prospect the virus's effects on male reproductive tissue, spermatogenesis, and semen parameters. Methods: PubMed and Scopus databases (papers published from 2020 to 2023) were searched for studies reporting the impact of COVID-19 on the related pathways associated with the male reproductive system at the level of cells, and 98 articles were reviewed. Findings: The effects of COVID-19 may arise directly due to the virus's attacks on the male reproductive system or may be due to an undesirable overreaction of the immune response, such as cytokines storm or fewer. Renin-Angiotensin System and PI3K/AKT signaling pathway are also involved; counts and sperm motility were decreased, although approximately recovery was observed in survivals within months. Contrasting the drugs used for treating COVID-19 that had contradictory effects regarding vaccines, it seems there is no tangible adverse effect on male fertility. Conclusion: The impact of SARS-CoV-2 on male fertility and the reproductive system is notable due to the presence of two major host factors, ACE2 and TMPRSS2, and involving the related pathways. It is possible that these organs could be involved, leading to effects on future generations. Understanding the process may provide a clue for managing the efficacies. © 2024 Isfahan University of Medical Sciences(IUMS). All rights reserved.