Does COVID affect male fertility?

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VB Health
April 5, 2023

A recent study of 120 Belgian men who recovered from COVID-19 infections suggests that SARS-CoV-2 (COVID) poses dangers to male fertility by affecting sperm motility and sperm count (1). 

The Short Answer.

This study suggests that COVID infections negatively affect sperm health in men for at least 3 months after their initial infection (1).

  • Researchers analyzed 120 men who recovered from COVID to determine if their sperm cells suffered DNA damage.
  • Sperm motility and sperm count were reduced in men for at least 3 months after COVID-19 infection.
  • Interestingly, the severity of COVID-19 infection and the presence of fever were not correlated with sperm characteristics. In other words, the primary factor in sperm damage is simply contracting COVID rather than how bad one's symptoms were. 

How did this study about COVID and sperm health work?

Researchers collected blood and semen samples from 120 Belgian men between the ages of 18 and 60 who had recovered from COVID-19 infections within one to eight weeks of collecting samples.

They tested for two main factors of semen health: sperm motility (how well sperm are able to move) and sperm count (the concentration of sperm in one's semen).

Sperm quality was assessed using the World Health Organization's criteria for semen characteristics (2). DNA damage to sperm cells was assessed by quantifying the DNA fragmentation index and the high density stainability. Finally antibodies against SARS-CoV2 spike-1 antigen, nuclear and S1-receptor binding domain were measured by Elisa and chemilumenscent microparticle immunoassays, repsectively.

What is a healthy sperm motility level?

Sperm motility is a measure of how well sperm cells are able to move. Healthy sperm motility is defined as sperm cells that have forward progression of at least 25 micrometers per second (3). 

Sperm motility is classified into four types:

  • Non-motile sperm (no movement)
  • Non-progressive sperm motility (less than 5 micrometers per second
  • Slow sperm motility (less than 25 micrometers per second)
  • Health sperm motility (over 25 micrometers per second)

Poor sperm mobility is classified as anything less than 25 micrometers per second, and is known as asthenospermia or asthenozoospermia. 

How does COVID affect sperm motility?

In this study, researchers found that sperm motility decreased in men that had recovered from COVID (1):

  • Within 1 month of recovery from COVID: 60% of men had reduced sperm motility.
  • Within 1-2 months of recovery from COVID: 37% of men had reduced sperm motility.
  • After 3 months of recovery from COVID: 28% of men had reduced sperm motility.

What is sperm count and what's a normal sperm count level?

Sperm count is a critical factor in male fertility. It refers to the number of sperm cells contained in a given volume of semen. It's typically measured in millions of sperm cells per milliliter (mL) of semen.

A normal sperm count ranges from 15 million sperm to more than 200 million sperm per milliliter (mL) of semen. Anything less than 15 million sperm per milliliter is considered to be a low sperm count (4).

How does COVID affect sperm count?

In this study, researchers found that sperm count decreased in men that had recovered from COVID (1):

  • Within 1 month of recovery from COVID: 37% of men had reduced sperm count.
  • Within 1-2 months of recovery from COVID: 29% of men had reduced sperm count.
  • After 2 months of recovery from COVID: 6% of men had reduced sperm count.

COVID and Fertility: Do vaccines affect male fertility?

study by the National Institutes of Health (NIH) followed more than 2,000 couples to find out if vaccination in the male, female or both affected the chances of conceiving a child. 

They found that there was no difference in the vaccinated couples as opposed to the unvaccinated couples

They also found that there is a slightly lower chance of conception in couples where the man had a COVID-19 infection within 60 days before the female’s menstrual cycle.

The moral of the story – get vaccinated if you're trying to conceive! If you’re a man, you’re less likely to experience fertility problems if you avoid a SARS-CoV-2 infection altogether.

COVID and Fertility: How long for sperm health to recover after COVID?

Researchers concluded that while semen is not infectious with SARS-CoV-2 after more than 1 week of COVID-19 infection, couples with a desire for pregnancy should keep in mind that sperm quality after COVID-19 infection is likely to be decreased. 

Based on this study, the estimated recovery time from COVID in terms of sperm health is 3 months. While it's not yet clear if sperm health is permanently damaged in men that contracted COVID, it is clear that many men see a significant decrease in sperm motility and sperm count in the months following their COVID infection. 

If you're trying to conceive and you just had COVID, it might be smart to wait until your body has a chance to regain its health before putting your sperm back to work.

If you have concerns about COVID-19 as it relates to fertility, semen quality, sperm count, sperm motility, sexual function, or reproductive health, make sure you talk to your doctor. Sexual function is vital to a person’s quality of life. 

✔️ References

1. Sperm quality and absence of SARS-CoV-2 RNA in semen after COVID-19 infection: a prospective, observational study and validation of the SpermCOVID test. doi: 10.1016/j.fertnstert.2021.10.022

2. World Health Organization reference values for human semen characteristics. Human Reproduction Update, Volume 16, No. 3 (2010). doi:10.1093/humupd/dmp048

3. Semen analysis and sperm function tests: How much to test? doi: 10.4103/0970-1591.78424

4. Semen Quality as a Predictor of Subsequent Morbidity: A Danish Cohort Study of 4,712 Men With Long-Term Follow-up. doi: 10.1093/aje/kwx067


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