The worldwide coronavirus infectious disease-19 (COVID-19) pandemic has touched all aspects of life and health. One of the silver linings of this strange time in history is that it has given partnered couples more time to be together at home. For a lot of couples, that has meant more time and opportunity to try to conceive a child. That brings up questions about whether or not and how COVID-19 might impact male reproductive health.
Experimental studies have shown that the SARS-CoV-2 virus that causes COVID-19 can bind to certain cell surface proteins in the testicles, which may explain why some men who are symptomatic with COVID develop testicular pain and inflammation (orchitis) during the acute phase of their illnesses. But what is the impact on male reproductive health after a man recovers from COVID? Is there a risk of sexual transmission of COVID-19 to a partner after recovery? How can COVID affect sperm quality and the chances of conception? We don’t have enough information to reach any definite conclusions, but the early clinical studies have mostly affirmed that sex and reproduction are safe during this pandemic.
The first question is whether or not there is evidence of live virus in semen or other fluids from the male urogenital tract after COVID-19 infections in men. If live virus is detectable in semen, that means COVID-19 could be transmitted through oral, vaginal or anal sex. Although one study did report detection of viral genetic material in semen during active infection, a more recent and larger study from Wuhan, China reported zero detection of SARS-CoV-2 RNA in semen, urine, or prostatic fluid from 74 men who had recovered from COVID-19. The samples were taken an average of 80 days after infection. This study suggests that there is very low risk of sexual transmission as long as couples wait 2-3 months to try to conceive after the male partner has recovered from COVID-19.
The other important question is how COVID affects sperm quality and male reproductive potential. The answer to this question is less clear. We also know that any viral illness can temporarily affect sperm quality for a few months, and so any impact may be nonspecific. Studies of semen quality after COVID-19 infections have generally shown minor but sustained declines in sperm count and sperm motility. The decline observed thus far in semen quality after COVID-19 infections would not be expected to have a major impact on the probability of conception. Furthermore, there is no evidence to date linking COVID-19 infections amongst male partners to higher miscarriage rates or health problems in conceived offspring.
Of course, it is VERY early in the game here. The first cases of COVID-19 occurred in China in very late 2019, and any children conceived during that time period have only just been born. At this moment in time, however, there are reassuring signals from clinical and basic science research that conception is likely safe during this pandemic. So what are you waiting for? There’s not much else to do during a lockdown….
