Determining the Reproductive Health of Men Post-COVID-19 Infection

NCT ID: NCT04414904

Last Updated: 2020-11-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2020-06-10

Study Completion Date

2020-06-10

Brief Summary

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Study rationale

1. An increasing proportion of the worldwide population is being infected with COVID-19.
2. There are ongoing and currently unanswered safety concerns about the effects of COVID-19 on reproductive health.
3. It will be immensely reassuring to rapidly report that COVID-19 has no detectable effects on male endocrine or sperm function. Conversely, if COVID-19 does impair male reproductive health, appropriate screening can be performed in couples trying to conceive, and further research can be undertaken.
4. The proposed study will be simple, rapid, and authoritative for the UK and worldwide.

Detailed Description

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Male infertility results from impaired sperm function, and account for half of all infertility. Fertility services have been reported to cost £325M annually in the UK(4) (REF). Testosterone deficiency is one of the most common hormonal problems affecting men, leading to osteoporosis, type 2 diabetes, obesity and depression(5).

Concerns have been raised about the potential effects of COVID-19 on male reproductive dysfunction (male infertility and testosterone deficiency). A recent study has suggested that COVID-19 may enter human cells by binding to receptors (special gates on cells that recognise a specific molecule) for angiotensin converting enzyme 2 (ACE2)(6) . ACE2 receptors are found at very high levels in the testes. Within the testes, ACE2 is found on developing sperm, the 'nurse cells' that help the sperm grow (Sertoli cells), and also on Leydig cells which are needed to make the male sex hormone testosterone. In summary, this evidence suggests that there is a plausible link why COVID-19 would cause male infertility and testosterone deficiency.

All fertility treatment in the UK is regulated by the Human Fertility and Embryology Authority (HFEA). The HFEA has prohibited on all non-cancer fertility treatment in the UK between April 15th and May 12th 2020 due to the COVID-19 epidemic. It is important to rapidly screen and report whether COVID-19 has any obvious effects in causing male infertility and testosterone deficiency. It must be noted that a recent study(1) reported that COVID-19 is not spread by human semen and therefore, semen processing should not risk staff to COVID-19 infection.

Conditions

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Infertility, Male Testosterone Deficiency

Keywords

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infertility hypogonadism

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Case group

* Men 18-50 years of age
* Already attending hospital for another reason
* High risk of prior COVID-19 infection:

* EITHER Prior positive COVID-19 PCR test result
* OR history suggestive of COVID-19 illness

Exposure: Covid-19 infection

Intervention Type OTHER

Previous history of COVID-19 infection.

Control Group

* Men 18-50 years of age
* Already attending hospital for another reason
* Low risk of prior COVID-19 infection:

* EITHER Negative positive COVID-19 PCR test result within last 4 weeks
* OR no history suggestive of COVID-19 illness

No interventions assigned to this group

Interventions

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Exposure: Covid-19 infection

Previous history of COVID-19 infection.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Men 18-50 years of age
* Already attending hospital for another reason
* Low risk of prior COVID-19 infection(EITHER Negative positive COVID-19 PCR test result within last 4 weeks OR no history suggestive of COVID-19 illness)
* High risk of prior COVID-19 infection(EITHER Prior positive COVID-19 PCR test result OR history suggestive of COVID-19 illness)

Exclusion Criteria

* Men with current symptoms of COVID-19 infection
* Men currently self-isolating as per UK government advice for COVID-19 infection
* Needle-phobia
* Impaired ability to provide full consent to take part in the study
* History of co-morbidity likely to affect male reproductive function e.g. undescended testes, removal of testes, testicular cancer, drugs such as corticosteroids or testosterone therapy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Channa Jayasena

London, Outside U.S./Canada, United Kingdom

Site Status

Countries

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United Kingdom

References

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Wang Z, Xu X. scRNA-seq Profiling of Human Testes Reveals the Presence of the ACE2 Receptor, A Target for SARS-CoV-2 Infection in Spermatogonia, Leydig and Sertoli Cells. Cells. 2020 Apr 9;9(4):920. doi: 10.3390/cells9040920.

Reference Type BACKGROUND
PMID: 32283711 (View on PubMed)

Wang S, Zhou X, Zhang T, Wang Z. The need for urogenital tract monitoring in COVID-19. Nat Rev Urol. 2020 Jun;17(6):314-315. doi: 10.1038/s41585-020-0319-7.

Reference Type BACKGROUND
PMID: 32313110 (View on PubMed)

Hackett G, Kirby M, Edwards D, Jones TH, Rees J, Muneer A. UK policy statements on testosterone deficiency. Int J Clin Pract. 2017 Mar;71(3-4):e12901. doi: 10.1111/ijcp.12901. Epub 2017 Mar 20.

Reference Type BACKGROUND
PMID: 28318076 (View on PubMed)

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, Wang W, Song H, Huang B, Zhu N, Bi Y, Ma X, Zhan F, Wang L, Hu T, Zhou H, Hu Z, Zhou W, Zhao L, Chen J, Meng Y, Wang J, Lin Y, Yuan J, Xie Z, Ma J, Liu WJ, Wang D, Xu W, Holmes EC, Gao GF, Wu G, Chen W, Shi W, Tan W. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020 Feb 22;395(10224):565-574. doi: 10.1016/S0140-6736(20)30251-8. Epub 2020 Jan 30.

Reference Type BACKGROUND
PMID: 32007145 (View on PubMed)

Related Links

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http://www.hfea.gov.uk

The state of the fertility sector 2017-2018

Other Identifiers

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20HH5998

Identifier Type: -

Identifier Source: org_study_id