COVID-19 has been found to reduce sperm count and motility

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus that causes Coronavirus 2019 (COVID-19), is capable of affecting various organs, including reproductive organs. The male genitourinary tract is particularly susceptible to SARS-CoV-2 infection due to widespread expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2), which are required for virus entry into cells.

Despite these interrelationships, few studies to date have investigated the effects of COVID-19 on male fertility, including semen quality. More research is needed to elucidate the impact of SARS-CoV-2 infection on reproductive health, especially in men.

A recent study published in the journal Scientific Reports evaluated sperm quality in men with infertility who had a previous SARS-CoV-2 infection.

How does COVID-19 affect sperm?

This study included both COVID-19-infected and uninfected men who donated semen samples while undergoing treatment at the Center for Reproductive Medicine in Shengjing, China. Sperm count, motility, morphology, and sperm DNA fragmentation index (FDI) and chromatin immaturity were measured in all semen samples.

About 83% of the 604 participants in the cross-sectional study were infected with SARS-CoV-2 virus, 140 of whom provided semen samples before and after COVID-19 testing. 149 semen samples from COVID-19-negative men were used as a control group.

Sperm count, Class A sperm count, which reflects sperm with rapid progressive motility, progressive motility, total motility, and sperm DFI were lower in samples from infected individuals compared to the control group, indicating poor semen quality due to COVID-19. These semen parameters were also reduced in patients after SARS-CoV-2 infection, but DFI was higher in these later samples.

COVID-19 negatively affected sperm DNA integrity.

A longitudinal study found that sperm quality in patients infected with SARS-CoV-2 was lower than in pre-infection samples. Notably, earlier control semen samples had lower semen quality compared to later samples, highlighting the beneficial effects of infertility treatment.

A larger proportion of COVID-19-positive patients had lower semen parameters than COVID-19-negative patients. For example, 75% of infected patients had a 21% increase in DFI after COVID-19 infection compared to pre-infection values. In the control group, 10% of late samples showed a deterioration in semen quality compared to early samples.

Almost 58 % of infected patients had reduced sperm counts in the second samples. More specifically, the sperm count was reduced by 12 %, corresponding to a loss of approximately 20.5 × 10⁶ sperm.

Approximately 70% of infected patients had a 17% decrease in total sperm motility. Similarly, in 71 % of infected semen samples, class A motility was reduced by 37 %.

Sperm DNA fragmentation may adversely affect the success of assisted reproductive technologies (ART), as sperm with high DFI are more likely to produce low-quality embryos, thereby increasing the rate of miscarriage and non-pregnancy. Thus, the persistently high DFI values in semen samples obtained after COVID-19 emphasize the potentially devastating impact of SARS-CoV-2 infection on male fertility.

Conclusions

After COVID-19 dissemination began, semen quality parameters decreased significantly when comparing infected patients and control groups, and between pre- and post-infection samples obtained from infected participants. These observations were similar in both cross-sectional and longitudinal studies, suggesting that COVID-19 significantly reduces semen quality.

COVID-19 has been associated with poor semen quality, as manifested by decreased sperm count and motility, and increased sperm DNA fragmentation.

Although COVID-19 is no longer considered a public health emergency, SARS-CoV-2 continues to circulate worldwide, acquiring new mutations that increase the virulence and adaptability of this pathogen. Overall, this study recommends that clinicians include COVID-19 screening or diagnosis in the evaluation of patients with male infertility.

Fertility Center IVMED Leave a request

Egyptian IVF Center Leave a request

Published: 02.05.2025

Updated: 02.05.2025

Medical author, Medical editor:

Stepan Yuk

Medical expert:

PhD. Olexandr Voznyak