- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04716179
Prospective Two-arm Study of Fertility in Men With COVID-19
Study Overview
Status
Conditions
Detailed Description
In late December 2019, the Chinese city of Wuhan witnessed the emergence of a form of pneumonia of unknown etiology. By the middle of January 2020, the disease had managed to spread beyond the country of origin and is now classified by the WHO as the largest pandemic in modern history.
Rapidly spreading and highly contagious, the infection prompted medical professionals all over the world to begin research into the virus with the goal of developing early diagnostic techniques and treatment strategies.
The new pathogen named SARS-Cov-2 belongs to the Coronaviridae family. These viruses cause severe acute respiratory syndrome (SARS-CoV-1, 2002-2003) and Middle East respiratory syndrome (MERS, 2012-2013).
The effects of SARS-CoV-2 on the human body stem from its structure. The spike proteins on the surface of the virus, which are responsible for the name "Coronaviridae," means that it is able to bind to the host receptor protein, angiotensin-converting enzyme 2 (ACE2). This makes cells with high quantities of these receptors on the surface susceptible to the virus.
The genome of SARS-Cov-2 responsible for the COVID-19 pandemic contains both human coronavirus fragments and bat coronavirus fragments (HKU9-1). It is the genetic material of HKU9-1 that makes SARS-CoV-2 unknown to the immune system of the human body.
As of today, three transmission pathways are recognized: close contact, airborne and fomite. Moreover, the virus is known to retain its contagious properties on surfaces for up to 72 hours, and the incubation period ranges between 2 and 14 days. Recent reports indicate that up to 80% of those infected by COVID-19 showed mild or moderate symptoms whereas 20-30% develop severe forms of the disease characterized by shock as well as respiratory and multiple organ failure. According to Chinese and Italian healthcare providers, the mortality rate is between 3.8 and 7.2%.
Zou et al. (2020) reported that non-respiratory symptoms may be explained by the binding of the virus to ACE-2 in other organs. Shen and Wang (2020) proved that ACE-2 is also expressed by testicular cells (namely spermatogonia, Leydig cells and Sertoli cells) which makes them potential targets for the virus. In fact, there are reports of orchitis and epididymitis in patients diagnosed with COVID-19. This means that SARS-CoV-2 may directly damage testicular tissue potentially compromising male fertility.
In a number of studies, PCR did not detect the virus in semen samples obtained during both the acute phase and recovery phase. In another study, postmortem needle and open biopsies of the testicles performed within an hour after death from COVID-19 revealed that testicular tissues were free of SARS-CoV-2 in 10 of 11 cases (91%). At the same time, spermograms in COVID-19 patients showed low ejaculate volume, sperm motility and sperm count. Previously, it was shown that COVID-19 has a severe effect on vasculature and therefore a microthrombi could be a possible contributor to fertility impairment. An assessment of testes with a Doppler enhanced ultrasound was therefore necessary.
Data dedicated to testosterone levels in the blood and inflammatory markers in the semen and testicular tissues is lacking. Available literature indicates changes in the above-mentioned parameters in males with verified COVID-19.
There is ultimately too little information to draw reliable conclusions regarding the effects of the virus on male reproduction. Published reports are limited by small study groups, lack of the control group and absence of follow-up examinations during recovery warranting further research and in-depth exploration of the topic.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Dmitry Enikeev, M.D.
- Phone Number: +79670897154
- Email: dvenikeev@gmail.com
Study Contact Backup
- Name: Mark Taratkin, M.D.
- Phone Number: +79670897154
- Email: marktaratkin@gmail.com
Study Locations
-
-
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Moscow, Russian Federation, 119991
- Recruiting
- Sechenov University.
-
Contact:
- Dmitry Enikeev, MD
- Phone Number: +7 925 517 79 26
- Email: enikeev-dv@1msmu.ru
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinical or imaging signs of COVID-19 infection
- Nasopharyngeal swab positive for SARS-CoV2 mRNA
Exclusion Criteria:
- Inability to collect semen for analysis
- Congenital anomalies of the testes
- Varicocele
- A history of fertility disorders
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patients with COVID-19
Patients with confirmed COVID-19 infection
|
The semen sample will be collected and analyzed within an hour after collection.
Hormone levels (testosterone, FSH, LH, prolactin) will be assessed on 5-7 days after symptom onset until the end of hospital stay.
SARS-CoV-2 Ig G levels will be assessed on 3 months after discharge
Postmortem examination of the testes of patients deceased as a result of COVID-19 infection will be carried out using immunohistochemistry analysis.
|
Other: Healthy participants
The controlled group with healthy participants without COVID-19 infection.
|
The semen sample will be collected and analyzed within an hour after collection.
Hormone levels (testosterone, FSH, LH, prolactin) will be assessed on 5-7 days after symptom onset until the end of hospital stay.
SARS-CoV-2 Ig G levels will be assessed on 3 months after discharge
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Semen quality analysis - motility
Time Frame: 3 months
|
motility of spermatozoa
|
3 months
|
Semen quantity analysis
Time Frame: 3 months
|
count of spermatozoa
|
3 months
|
Semen quality analysis - shape
Time Frame: 3 months
|
shape of spermatozoa
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Testosterone
Time Frame: 3 months
|
testosteron (ng/dL) level in the blood test
|
3 months
|
FSH
Time Frame: 3 months
|
Follicle-Stimulating Hormone (IU/L) level in the blood test
|
3 months
|
LH
Time Frame: 3 months
|
Luteinizing hormone (IU/L) level in the blood test
|
3 months
|
Prolactin
Time Frame: 3 months
|
prolactin (ng/ml) level in the blood test
|
3 months
|
Damage of the testes on pathology
Time Frame: 3 months
|
Damage of the testes assessment using imminohistochemistry at autopsy specimen
|
3 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Dmitry Enikeev, M.D., Sechenov University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- RNA Virus Infections
- Virus Diseases
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Pneumonia, Viral
- Pneumonia
- Lung Diseases
- COVID-19
- Infertility
- Physiological Effects of Drugs
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Androgens
- Hormones
- Testosterone
Other Study ID Numbers
- COVID-MFert-20
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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