The COVID-19 virus is known to infect and destroy many different types of cells, and new research suggests that infection may impact sperm quality.
Since the arrival of the pandemic in 2019, there has been widespread research on how the virus impacts the body upon infection. One area of research has focused on the impact of COVID-19 on male reproduction, specifically sperm quality.
How can a COVID-19 infection affect sperm quality?
Currently, there is no evidence that COVID-19 can spread through semen or vaginal fluids. However, it appears that infection with COVID-19 may result in a temporary reduction in testosterone levels and measures of sperm quality in some individuals. The level of these decreases seems to depend on infection severity.
One study by Holtmann et al. (2020) analyzed sperm samples from 18 patients one month after recovering from a COVID-19 infection and 14 control patients1. They found that:
Patients with mild infections that did not require hospitalization did not show any difference in sperm quality after one month1
Patients who had moderate infections showed a decreased concentration of sperm, less sperm per ejaculate and a general decrease in motility1
Up to 19% of COVID-19 patients experienced testicular pain, which may indicate viral orchitis (inflammation of one or both testicles)1
While these are not typical symptoms of a COVID-19 infection, all of the above effects may be associated with reduced fertility.
However, is this decrease in sperm quality due to the virus itself, or does it have more to do with the body’s reaction to the virus? It turns out, infections such as human immunodeficiency virus (HIV), STIs, urogenital infections and human papillomavirus (HPV) are also associated with a reduced quality or quantity of sperm2.
When the body is actively fighting off a virus, it leaps into action and initiates the production of immune cells to fight the invading pathogen cells. These immune cells release “danger” signals that trigger inflammation in the body. While inflammation helps to join the fight against the pathogen, it can also cause damage to healthy tissue. In the reproductive system, this might be the glands or tubes that help produce or transport healthy sperm cells and seminal fluid2. This is why infections triggering significant amounts of inflammation may temporarily harm sperm production and function.
How does this affect individuals going through fertility treatments?
There is no question that the pandemic has tremendously impacted fertility care, whether it be due to cycle interruptions, extra mental health burden due to restrictions, or other measures. However, there is one significant concern among fertility care teams: does COVID-19 impact male and female reproductive health? More specifically, is there a risk of COVID-19 cross-contamination in the embryology lab?
Fortunately, studies have found that the COVID-19 virus is not found in semen or vaginal secretions. In a fertility clinic setting, this means that there is likely little to no risk of cross-contamination3. This is good news for medical team members because if cross-contamination was possible, eggs could become infected in the laboratory, or eggs/embryos might infect others while being stored frozen.
The COVID-19 vaccine doesn’t appear to affect sperm quality – why?
One driving force of vaccine hesitancy is the fear that it may negatively affect fertility. However, infection-associated changes to sperm quality were not seen after the mRNA vaccine.
As the vaccine is mRNA-based and does not contain a live virus, these results are intuitive. The COVID-19 vaccines are designed to stimulate an immune response and a “memory” of infection without contracting a COVID-19 infection. The immune response triggers the production of immune cells specifically designed to attack an actual COVID-19 virus. These cells then circulate, lying in wait for a virus to enter your system. As these immune cells do not mount an attack without an invading virus, they should not cause damage to reproductive tissue, and thus sperm quality and quantity should not be affected.
To avoid potential infection-associated effects of COVID-19, every individual is recommended to be vaccinated against COVID-19 if they are able to. Given a possible association between a COVID-19 infection and reduced sperm quality, it is especially important that those who are looking to conceive are vaccinated against the virus.
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Chloe Graham (she/her)
Doctoral Student (University of Guelph, Biomedical Sciences)
About the author
Chloe is a Masters Student in Biomedical Sciences at the University of Guelph, who also works as a patient coordinator at Anova Fertility.
At Anova, she educates patients through creating online resources, manages patient flow and assists with administrative functions. Before joining our team, Chloe advocated for women’s health and reproductive rights as an executive member of Oxfam at Guelph, local branch of the international anti-poverty organization.
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