0

COVID-19 and Male Fertility – The Update

COVID-19 And Male Fertility – The Update
Facebook
Twitter
LinkedIn
Email

We use Advanced AI to translate our blog content. If the translation isn’t perfect, or if you have any queries about the content, our medical team is readily available to answer. Simply email [email protected]

How COVID-19 affects sperm?

 

A year on from our (first) lockdown, we wanted to refresh this blog, which was originally posted in April 2020, with the latest research into the impact of Covid-19 on sperm health. 

As most of us will know by now, Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by the coronavirus, also called SARS-CoV-2. The most common symptoms of the coronavirus are fever, tiredness, and dry cough. The virus primarily affects the lungs, as we also see in typical influenza during the winter period. Still, the coronavirus can also enter other human organs that possess the entry protein that the virus uses to enter cells (ACE2). 

But should you fear COVID-19 when it comes to male fertility? What research has been done so far and what have we learned? 

Can the effects of Covid-19 impact sperm indirectly? 

 

In 2020, an early report from Chinese doctors in the Wuhan province suggested that the virus could cause testicular damage. The small report was not enough to draw any conclusions. Therefore, only a few hours after uploading, they deleted it. Since then, there have been further studies on this topic. Although most of them have still been relatively small, they do give some indication as to how Covid-19 could impact sperm health.

A paper published by the journal EClinicalMedicine at the tail end of last year investigated samples from the testis and epididymis (the tube that transports sperm from the testis) of 6 male Covid-19 patients who had passed away and 23 men who were recovering from mild or moderate cases of Covid-19. They did a number of tests, comparing them to men of similar ages who had not had the virus. 

Of the men recovering from Covid, 39% of them had low sperm counts – even though they all had at least one child before contracting the illness. Another interesting discovery was that 61% of the men had an increased number of white blood cells in their semen – which is usually a sign of inflammation – and potentially damaged sperm. Inflammation was also found in the samples taken from men who had died from the virus. 

Research is still inconclusive 

 

Whilst this study shows us some useful data, it’s important to remember that this was a very small sample size – and the researchers did not know what their sperm count or quality was like before they had Covid-19.

Another recent study, again indicated that Covid-19 could impact sperm directly, however, the results have also been brought in to question by fertility experts including Dr Alsion Campbell, Director of Embryology of the CARE Fertility Group who said ‘Overall, men should not be unduly alarmed by this research”. The prospective, cohort study published in Reproduction focused on 84 previously fertile men who had contracted Covid and tested their sperm at 10-day intervals over 60 days. One of the main issues experts have with the study is that they only tested for 60 days, even though we know that sperm regenerates every 72-90 days. 

Whilst the results may indicate short term damage to sperm cells when battling – and being treated for – Coronavirus, this study fails to show us whether this damage is a concern for the long term. Professor Allan Pacey, Professor of Andrology at the University of Sheffield commented “It would have been more useful to see whether there was a difference at 90 days between the two groups. A paper published last year suggested only a small difference in sperm concentration existed by that time.”

Can the effects of Covid-19 impact sperm indirectly? 

 

Hormonal disorders 

 

Recent studies have also highlighted how the impacts of Covid could have an indirect effect on sperm production – particularly via the nervous system. It has been reported that the brain cells (glial cells and neurons) also express ACE 2 receptors, making them a possible target to induce neuronal death for SARS‐CoV‐2. Importantly, the central nervous system plays a critical role in endocrine control and spermatogenesis. Neurons in the hypothalamus secrete a gonadotropin-releasing hormone (GnRH), for example, which triggers the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. Low levels of GnRH results in decreased FSH and LH, which in turn impacts the function of Sertoli cells and Leydig cells which may induce lower sperm quality. 

Schematic representation of the regulation of HPG axis in healthy and COVID-19 conditions.

Figure A represents the healthy human brain and testes in association with the HPG axis. Figure B represents a SARS-CoV-2 infected human brain and testes with neuroinflammation and dysregulation of the HPG axis in association with reduced steroidogenesis and spermatogenesis due to testicular inflammation and oxidative stress.

 

Covid 19 and fertility

Mental Health

 

Another way in which Covid could indirectly affect sperm health is its impact on our mental wellbeing. Depression and anxiety – which have increased for the general population during the pandemic, and have particularly affected those who have suffered from Covid 19 – are associated with increased levels of cortisol and prolactin – hormones associated with stress. This can have a knock-on effect on male fertility – you can read more about the impact of stress on sperm production here. 

 

How other viruses impact sperm count and quality

 

Whilst we wait for more research to be undertaken, we can look at how other, similar infections impact the body. We also know that many different factors both inside and outside the human body affect sperm production. Scientific papers show that infections that increase body temperature have a negative impact on semen quality. This is most likely a response to the increased heat, which harms semen quality. Interestingly, a case study from 2007 showed that fevers could have marked effects on not only semen parameters but also the sperm’s DNA [3]. This was a relatively short-term effect, normalizing about two months after the fever.

Genital tract infections can affect sperm directly, while viruses or bacterial infections not entering the genital tract may lower sperm production due to the fever effect [1][3]. One of the most well-known virus-induced infections leading to infertility is mumps. Infection with mumps results in an inflammation of the testicles (orchitis), causing permanent damage.

 

But are there any permanent effects of COVID-19 on male fertility?

First of all, it is essential to say that there are many people who have become infected with COVID-19 that don’t show any symptoms or feel unwell. Secondly, researchers have so far confirmed that about 80% of those infected with COVID-19 recover from the disease without needing special treatment. At present, it is too early to conclude anything about the permanent effects of a COVID-19 infection on male fertility.

The fever-effect of a coronavirus infection is, if it occurs, most likely a short-term effect. This was demonstrated in a case study from 2007 where the semen parameters return to the pre-fever levels approximately two months after recovering from the fever [3].

Covid19 graph

What to do in case of any concerns?

You can evaluate your sperm health with a sperm test. An easy and accurate way of doing this could be the ExSeed at Home sperm kit. It includes five sperm tests. This way you can test your current sperm quality and track sperm parameters over time if you have any concerns.

Facebook
Twitter
LinkedIn
Email
ExSeed home sperm test kit 2 test
ExSeed Home Sperm Test Kit (2 tests)

£74.99

ExSeed-Refill-Kit.png
Refill Kit Monthly Subscription

£24.99 / month

combi-2-min.png
ExSeed Combi

£24.99£74.99

More to explore

Our products

ExSeed home sperm test kit 2 test
ExSeed Home Sperm Test Kit (2 tests)

£74.99

refill-1-min.png
ExSeed Refill Kit (5 tests)

£79.99

combi-2-min.png
ExSeed Combi

£24.99£74.99

Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.

Stress

Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.

Nutrition

Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Vegetables
Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.

Heat

Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.

BMI

There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  

Alcohol

A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.

Age

Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.