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News about the potential impact of COVID-19 on spermatogenesis and findings related to pregnancy in patients with breast cancer helped make fertility this week's top trending clinical topic. Recently, several small autopsy studies have explored the effects of SARS-CoV-2 on male fertility (see Infographic below). Researchers from Florida compared testis tissues from six men who died of COVID-19 with tissue from three who died of other causes. They found that three members of the COVID-19 cohort had damage that would impair sperm production. An inverse association between ACE2 receptor levels and spermatogenesis was noted.
These findings echo similar observations from a report out of China earlier this year. That study found "significant damage" to the basic cellular testicular tissue in 12 men who died due to COVID-19. Norwegian researchers are currently further investigating the effects of the new coronavirus on sperm. The team is studying messenger RNA to look for clues as to how genetic alterations due to infection may alter production of proteins involved in the immune system and the potential effects on fertility and future offspring. The hope is that the findings will allow for guidance about how long those with COVID-19 should wait before having children.
In non-COVID news, a recent study suggests that nighttime smartphone or laptop use may impair male fertility. Preliminary results from a small study show an association between increased self-reported exposure to light-emitting media devices in the evening and after bedtime and decline in sperm quality. Both sperm concentration and motility were lower, and the amount of immotile sperm was higher, among men who reported increased use of these devices at night.
Recent fertility-related news for a specific group of women is more encouraging. A review of more than 1000 young women found that pregnancy after treatment for breast cancer with BRCA mutations is safe, with excellent fetal outcomes and no increase in cancer recurrence. Researchers say the study's results should help reassure patients with BRCA-mutated breast cancer who are interested in future fertility.
A separate study out of Sweden found that women with breast cancer who undergo fertility preservation are more likely than those who don't to have successful assisted reproductive technology (ART) treatments and live births, without added mortality risk. Researchers investigated data from 425 women with breast cancer who underwent fertility preservation, as well as 850 women matched by age, location, and time of breast cancer diagnosis who did not undergo such preservation. Researchers say the results underscore the importance of clinicians discussing this option with patients.
From encouraging news about pregnancy among patients with breast cancer to worrisome findings regarding spermatogenesis in men with COVID-19, fertility was a subject of much interest and became this week's top trending clinical topic.
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Cite this: Ryan Syrek. Trending Clinical Topic: Fertility - Medscape - Dec 11, 2020.