Covid-19 infections can lower sperm count and the virus may even bind to receptors on the surface of sperm cells. However, there is no evidence to suggest that the effects differ to those seen after other illnesses that involve fever, such as the flu.
at Oasis Fertility, a fertility clinic in India, tracked sperm counts in 20 men aged 25 to 35 from before they had a SARS-CoV-2 infection to nearly five months after they had fully recovered 鈥� that is, were testing negative and had no symptoms. The researchers didn鈥檛 explicitly look at sperm in trans women or non-binary people 鈥� this was the case for all the studies mentioned in this article.
The men visited the clinic prior to the pandemic because they had been unsuccessfully trying to conceive for at least a year. Of the 20 men, six saw no decline in sperm count around 10 weeks after recovering from covid-19, while the other 14 had an average 49 per cent decline in the same period.
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The team measured the sperm counts of these 14 men again around 11 weeks later and found that levels had recovered somewhat for 11 of them, to an average of 12 per cent lower than prior to infection. The other three men鈥檚 sperm levels did not recover at all in this time period. Chaitanya Mantravadi presented the findings at the (ESHRE) conference in Milan, Italy earlier this month.
鈥淔or some men we just do not know if the effect on semen parameters is permanent,鈥� , an NHS consultant based at the University of Glasgow, UK, said during a separate presentation at the conference, adding that more data on how sperm impairments caused by covid-19 can affect conception is needed.
鈥淚f you鈥檝e got a sperm count of, say, 120 million, the chances are that even if they take a hit, you still would have a count of 60 million and you鈥檙e still probably going to be able to conceive naturally,鈥� said Nelson.
This isn鈥檛 the first study to suggest that infection with the SARS-CoV-2 virus may lead to a temporary drop in sperm count. A 2021 study led by at University Hospital Antwerpen in Belgium analysed sperm samples from 67 men with an average age of 34 after they had tested positive for covid-19.
The researchers analysed the sperm of 35 of these men within a month after they had a positive PCR test, and found a below average sperm count 鈥� defined as less than 15 million sperm cells per millilitre of semen 鈥� in 13 of them. The team analysed the sperm of the other 32 participants at about two months after a positive test, and found just two participants had a below average sperm count, suggesting sperm counts recover over time. This study didn鈥檛 assess sperm counts in the participants prior to catching covid-19.
at the University of Monastir in Tunisia and her colleagues also presented evidence of covid-19鈥檚 effects on sperm motility at ESHRE. They collected two sperm samples, one before and another during the pandemic, from 90 people with an average age of 38, and found an average 5 per cent reduction in the proportion of sperm that could swim. However, this study didn鈥檛 test whether participants had covid-19.
Covid-19 may affect sperm by damaging the tissues that support their development. and the epididymis, the tube where sperm cells mature. These both carry the ACE2 receptor that the virus uses to gain entry to cells. found that 11 appeared to have inflammation of the epididymis.
There is also evidence that SARS-CoV-2 may be able to directly bind to sperm cells. In a study presented at the conference by at the University of L鈥橝quila in Italy and her colleagues, the team found that ACE2 receptors were present on the surface of sperm cells from 40 sperm donors. However, the virus has not yet been found inside sperm cells.
As sperm cells don鈥檛 produce proteins, the researchers don鈥檛 think the virus could replicate itself inside sperm, if it managed to infect these cells. But they say that it can鈥檛 be ruled out that the virus could have some effects on sperm by interacting with their cell membranes.
SARS-CoV-2 has also rarely been found in the seminal fluid that carries sperm. Pedro Jose Fern谩ndez-Colom at the La Fe University and Polytechnic Hospital in Spain and his colleagues presented work at ESHRE in which they analysed sperm donated by 50 men between July 2020 and March 2021. They found SARS-CoV-2 in one semen sample. He told New 杏吧原创 that the presence of the virus in semen was rare but not impossible. There is no evidence it can be transmitted sexually through semen, he says.
The effects of covid-19 on sperm varies substantially between individuals, said Chaitanya Mantravadi. 鈥淎t this point I would say not to worry too much about it,鈥� he told New 杏吧原创. 鈥淚f you are concerned about your fertility, you could look into freezing some sperm, or you could take a quick sperm test.鈥�
Overall, the effects of covid-19 on sperm are similar to those seen after other illnesses that involve a fever, such as the flu, because sperm are highly sensitive to temperature changes.
鈥淭he data suggests that men with moderate to severe disease may suffer a temporary reduction in semen quality, in the same way that is seen with other illnesses [that cause fever],鈥� says at the University of Sheffield, UK.
鈥淎s such, I am no longer concerned about any long-term effects for male fertility of a covid-19 infection and see this as no more serious than what we see following an infection of influenza.鈥�
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