We have been living with the COVID-19 pandemic since December 2019. As life goes on, couples planning to start their families have been asking: “Does COVID-19 and the COVID-19 vaccine affect sperm and male fertility?”
There have been multiple studies published on these topics. I have given a summary of their findings and picked out a few bigger or more recent studies to go into some detail.
First some definitions and use of terms.
SAR-CoV-2 is the name of the virus that causes COVID-19
COVID-19 is the name of the disease caused by an infection with virus SARS-CoV-2
Does COVID-19 infection affect male fertility?
Overall the answer to this question is Yes. There have been a number of studies detailing how COVID-19 causes inflammation of the testes. And consequently a reduction in the number of sperm produced as well as an increase in the DNA damage in the sperm. Some studies also reported a decrease in sperm motility and well as increased derangements in sperm morphology (size and shape). There have been studies to show that the cellular receptors that the SARS-CoV-2 virus targets are found on the testes, sperm and other parts of the male reproductive tract like the prostate.
An article published very recently in March 2021 of 43 men who recovered from COVID-19 found that 25% of them had a reduced sperm count as well as sperm that was of poorer morphology (size and shape). This was in spite of the fact that there was no viral genetic material detected in the semen. Also, the men who had a more severe COVID-19 infection also had poorer sperm count and quality.
Another review paper published slightly later in Jan 2021 referencing 57 other papers concluded that COVID-19 infection does cause testicular injury and inflammation and alters sperm parameters. In fact, the paper stated that COVID-19 infection can cause inflammation of the testes to a point as to cause pain in the scrotum. It further concluded that COVID-19 infection reduces the number of sperm produced and also caused more DNA damage in the sperm.
Another study published by a Chinese team in Nov 2020 also found that patients who recovered from COVID-19 had a lower sperm count and poorer sperm morphology. They also found evidence of damage to the testes by the immune system as triggered by COVID-19. So Theorized that this is one of the ways a COVID-19 infection can cause the sperm to become unhealthier.
A study hypothesized the possible mechanisms by which SARS-CoV-2 virus can affect the male reproductive system. The theory is that the receptors that the COVID-19 virus binds to are also present on the sperm and many parts of the male reproductive tract including the testes and the prostate
Is COVID-19 sexually transmitted?
I added this in here because there was a time this was headline grabbing. However, in my opinion, this is just a click-bait. Although there are some small scale studies that found the SARS-CoV-2 virus in semen, it is very unlikely to contribute significantly to overall contagion. Seeing how we now know the virus is not only spread by respiratory droplets but also airborne.
A review paper published in Dec 2020 looked at 9 different previous studies published on detecting the presence of SAR-CoV-2 virus in the semen. Most of the studies did not detect any COVID-19 virus in both patients who had an active infection as well as patients who recovered from the infection. Only one study published by a Chinese team in May 2020, detected the presence of COVID-19 virus in the semen. However, the authors of the review paper noted that the methodology used by this paper to detect the virus lacked some technical details therefore putting their conclusion into question.
Does the COVID-19 vaccine affect male fertility?
A small Israeli study involving 43 men found that the Pfizer-BioNtech COVID-19 vaccine had no effect on sperm parameters. This is a small study so although promising, more data would be needed to verify this finding. Also, this finding cannot be extrapolated to the other COVID-19 vaccines.
In conclusion
Can COVID-19 affect male fertility?
Most of the evidence available point to the fact that a COVID-19 infection can cause inflammation of the testes and negatively affect sperm parameters. So yes, COVID-19 infection can affect male fertility. For young men who have been infected with COVID-19 and are planning to start a family, they may want to speak to their Doctors about undergoing a semen analysis.
Can COVID-19 be sexually transmitted?
Although there are some small studies to show that the SARS-CoV-2 virus has been detected in the semen, there are even more studies to show that there isn’t. Even if the COVID-19 virus is detectable in the semen, it is very unlikely to contribute significantly to infection as the virus is already spread via respiratory droplets and airborne route.
Can the COVID-19 vaccine affect male fertility?
As of the writing of this article, I am only aware of 1 small study on the effect of the Pfizer-BioNtech COVID-19 vaccine on sperm parameters. The study concluded that the Pfizer-BioNtech COVID-19 vaccine does NOT affect sperm parameters. This is a small study and we should wait for more data to be available before reaching a conclusion. Also, this conclusion cannot be extrapolated to the other COVID-19 vaccines.
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