Affects of COVID-19 on male fertility

By Ian Stones

The impact of Covid on our lives has been immense and for those going through fertility treatment it’s undoubtedly caused a lot of anxiety and stress.

However, there is one element that has seen little coverage; the potential impact of Covid on male fertility.

With such a rapidly changing situation it’s hard to keep up with everything and the main focus has, quite rightly, been on vaccines and keeping us all safe.

So it’s no surprise to find little research out there around male fertility and Covid, in fact there is only one study on the effect of Covid and semen parameters and not one single study looking at the impact of Covid on treatments such as IVF.

Where there have been studies the results are quite varied and the quantity and quality of the research doesn’t allow for strong conclusions to be drawn.

How does COVID-19 affect sperm?

There are 2 key areas where the virus may have a profound effect on sperm quality:

  1. Oxidative stress and free radicals
  2. Heat

Any virus such as a Covid creates an immune response which will often cause a fever. This is what our body does to fight off infection; basically kill it with heat.

This is great but of course we know that heat is detrimental to sperm health so any substantial fever is going to be problematic.

Unfortunately there is little you can do about the fever other than to take medication to reduce it and let nature take its course. 

Another side effect of a virus is inflammation created by our immune response. Your body naturally goes into a state of war fighting off the virus and the fallout of that is increased inflammation and an increase in what’s known as oxidative stress.

Oxidative stress results in additional damage to cells around the body and is actually something that is going on day to day and definitely impacts sperm health.

When we’re facing a strong virus such as Covid the damage from the fever and inflammation can be significant. So it’s only natural to assume that if you’ve had a particularly strong immune response to Covid then there is likely to be a negative effect on your sperm quality.

Is there a risk of long-term damage?

From the research there is some concern that the virus could also cause damage to important parts of the testes where sperm production is taking place. This evidence is currently inconclusive, but we know that other viruses such as mumps can cause swelling in the testes and long term damage. If Covid also causes swelling of the testicles, which it may, then there is the potential that it could cause long term damage so it’s an important consideration.

Freezing your sperm with COVID-19

Some research has specifically looked at whether the Covid virus has been able to pass into the seminal fluid.

Again this has shown mixed results but one paper did report that the virus had been found within men’s semen.

The research suggests that some consideration should be given to this when freezing sperm if you’ve had the virus so, if this is part of your treatment plan make sure you discuss it with your consultant.

What should you do if you contract Covid?

It’s not all bad news and I wanted to share this information so that you’re properly informed and prepared.

The good news is that men are constantly producing fresh sperm on a 90 day cycle so any damage is hopefully only temporary.

If you have been affected by the virus you should give yourself time to recover and replenish your stores of healthier sperm. Remember that the sperm you produce in a sample for assessment or fertility treatment was produced 90 days prior. This means you won’t see the impact of any illness on your sperm quality until 3 months later!

The best way to improve sperm quality is to concentrate on things like diet, lifestyle, stress and exercise. Taking the right supplements and keeping hydrated are key.

Foods rich in antioxidants can help to combat the damaging effects of free radicals. A diet high in good quality fruit, vegetables and unprocessed meat is essential, because of their antioxidant elements and their high content of vitamins and minerals.

Antioxidant-rich foods include:

  •     Fresh vegetables
  •     Fresh fruit – grapes and blueberries
  •     Dark leafy green vegetables
  •     Fish
  •     Nuts and seeds
  •     Pulses and beans

Keeping well hydrated is also an essential part of maintaining healthy sperm.

Book a male fertility checkup

If you’re particularly concerned then book yourself in for a male fertility check, in fact I would suggest this for any man who’s experienced strong Covid symptoms. You can do this through your IVF clinic or look for a Urologist with male fertility experience. Getting a standard semen analysis is easy and you may want to consider further testing if you’ve been particularly unwell.

Also, look at getting some help around managing your diet, lifestyle and stress so that you can really have a positive impact on your sperm health and recovery.

The important thing is to actually take action and speak to someone. Don’t assume all is ok only to find out later when it’s too late.

The thoughts of Professor Luciano Nardo

Luciano NardoAs Covid-19 spreads around the world and throughout the UK, our patients seek advice regarding how best to preserve and maintain their healthy fertility potential. As elegantly presented by Ian Stones, there is still lack of knowledge and evidence of the impact of SARS-CoV-2, the virus responsible for Covid-19 infection, on sperm and more generally reproduction. The profession is waiting for guidance based on epidemiological data and learned societies recommendations. Nonetheless, men that have been diagnosed with Covid-19 and have had symptoms of testicular pain or discomfort and those at high risk** of experiencing complications of the virus should consult a male fertility specialist. Remote two-way consultations are easily available as first line management, whereas physical examination, ultrasound assessment and semen analysis may be arranged on individual cases.

** High risk groups include:

  • Recipients of organ transplant
  • Men with respiratory conditions including severe asthma
  • Men with homozygous sickle cell disease
  • Men receiving immunosuppression therapies
  • Men who have had previous testicular or scrotal traumas, infections and/or surgery
  • Men who are smokers

Ian Stones

Ian StonesIan is a leading fertility and wellness expert with a passion for helping men get the support they need throughout fertility treatment.

Ian offers personalised 1:1 support allowing men to feel empowered and in control of their fertility. Ian co-hosts a monthly male only support group on behalf of Fertility Network UK and is coordinating a male fertility campaign and fundraiser to Everest base camp.

If you’d like to find out more or to arrange a free discovery consultation you can contact him on ian@hovefertilityandwellness.co.uk or call 07740 300465.