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Hepatitis and male fertility: symptoms, trying to conceive, and more

Does hepatitis impact male fertility? This is a complicated subject to tackle because there are several different types of hepatitis, each with their own treatment methods and potential risks. For example, hepatitis B and C are associated with an increased risk of preterm delivery and can also be transmitted from gestational carrier to baby.

However, safely having children isn’t impossible if you have hepatitis. While there are potential risks to be aware of — and research that suggests hepatitis can negatively impact male fertility — planning a family begins with understanding your state of health.

Key takeaways:

  • Hepatitis is inflammation of the liver, and can have viral and non-viral causes.
  • Hepatitis B is a viral type of hepatitis that is most commonly associated with sexual transmission and infertility.
  • It is possible to conceive if you have hepatitis or have had it in the past, but prompt treatment is critical.

What is hepatitis?

Hepatitis is a condition that is characterized by inflammation of the liver. People can get acute (short-term) or chronic (long-term) hepatitis. Depending on the severity of the case, hepatitis can cause major health complications, such as scarring of the liver, liver failure, or even liver cancer. If you experience any symptoms of hepatitis (outlined below), it’s important to immediately visit a doctor. Early diagnosis and treatment can help prevent these health complications from developing.

What causes hepatitis?

Hepatitis can be caused by a virus (most commonly) or non-virally. There are five viral strains of hepatitis. If a person has a hepatitis virus, they can spread the virus through blood and other bodily fluids.

In the case of non-viral hepatitis, the condition can be brought on by heavy alcohol consumption, autoimmune disorder, or by exposure to toxins, chemicals, or particular medications and drugs.

Types of hepatitis

Hepatitis A

Hepatitis A is an acute type of hepatitis that is caused by the hepatitis A virus (HAV). This virus is typically transmitted by consuming contaminated food or water. This is a highly contagious infection — approximately 1.4 million people are infected with hepatitis A every year.

Fortunately, there are no known long-term side effects of contracting hepatitis A, and most infections will clear up on their own. The average recovery time is one week after symptoms appear.

To prevent contracting hepatitis A, it’s important to wash your hands before eating, rinse produce before eating it, drink clean water, and eat food that has been prepared and cooked under food-safe conditions. 

Hepatitis B

Hepatitis B is usually transmitted through contact with bodily fluids — like blood, vaginal secretions, or semen — containing the hepatitis B virus (HBV). This means hepatitis B can be spread by having sex with an infected partner, or sharing razors or needles with an infected person.

In most cases, the hepatitis B infection will clear up on its own after several weeks. In rare cases, some adults with hepatitis B may become long-term carriers of the virus with a chronic infection. According to the CDC, approximately 1.2 million people in the United States have hepatitis B, with most unaware that they have an infection.

Hepatitis C

The hepatitis C virus (HCV) is usually transmitted through direct contact with infected bodily fluids, much like the hepatitis B virus. Hepatitis C is one of the most common types of hepatitis, with approximately 2.7–3.9 million people in the United States living with a chronic form of hepatitis C.

Many people believe that hepatitis C can be transmitted simply by hugging, kissing, or sharing food or dining utensils with an infected person, but this is untrue. HCV is most commonly transmitted by sharing needles, razors, or toothbrushes, or via sexual contact. In some cases, people can contract hepatitis C by getting a tattoo or piercing with non-sterile equipment. Hepatitis C can also be passed from a gestational parent to their baby during childbirth.

Hepatitis D

The hepatitis D virus (HDV), also known as delta hepatitis, is a “satellite virus” of HBV, meaning it’s only transmitted in conjunction with the hepatitis B virus. HDC is contracted through direct contact with infected blood and is very rare

Hepatitis E

The hepatitis E virus (HEV) is waterborne. Hepatitis E is very rare in the United States; most cases of hepatitis E occur in still-developing areas in the Middle East, Asia, Central America, and Africa with inadequate water supply and poor sanitation. If fecal matter finds its way into the water supply, ingesting that contaminated water can cause hepatitis E.

Alcoholic or toxic hepatitis

As the name suggests, alcoholic hepatitis is caused by excessive consumption of alcohol. One of the primary jobs of the liver is to filter toxins and waste from your body, and one of those substances it filters and breaks down is alcohol. If someone drinks more alcohol than their liver can process, they could develop alcoholic hepatitis, which can eventually lead to liver failure. Although the development of alcoholic hepatitis usually occurs over the course of years of over-drinking, it is possible to develop a case of acute alcoholic hepatitis.

Similarly, toxic hepatitis is caused by exposure to chemicals or drugs that overwhelms the liver. A person who is frequently exposed to toxic chemicals due to their line of work — either by ingesting, breathing, or coming into direct contact with chemicals — may be at greater risk of developing toxic hepatitis.

Toxic hepatitis can also be an extreme side effect of some prescription or over-the-counter medications. For this reason, it’s important to stick to the recommended or prescribed doses for any medications and to communicate any alarming symptoms — like nausea, vomiting, jaundice, pain, or fever — with your primary care physician right away.

Autoimmune hepatitis

Autoimmune hepatitis occurs when your body’s immune system begins mistakenly attacking your liver cells. The cause for autoimmune hepatitis is unknown. Some research shows that autoimmune hepatitis is more likely to occur in people with ovaries instead of people with testes. It’s also more likely to occur in people with other autoimmune conditions, such as thyroiditis, Grave’s disease, type 1 diabetes, Celiac disease, or ulcerative colitis.

Symptoms of hepatitis

Although there are many types of hepatitis, there are several symptoms that are universal, including:

  • Fatigue
  • Jaundice (yellowing of skin and eyes)
  • Dark urine
  • Pale stool
  • Abdominal pain
  • Loss of appetite
  • Unexplained weight loss
  • Flu-like symptoms

In acute hepatitis, symptoms come on strongly and suddenly and may be easier to recognize. On the other hand, chronic hepatitis develops slowly, which can make noticing symptoms more difficult.

Is hepatitis a sexually transmitted infection?

Viral hepatitis can be transmitted through blood and other bodily fluids, including sexual fluids. Each viral strain has a different risk of being transmitted through sex. 

Hepatitis B is most commonly linked with sexual transmission. The hepatitis B virus is present in semen and bodily fluids shared between two partners during unprotected sex.

You can also contract hepatitis A through sexual contact, though it is far more common to get hepatitis A by consuming food or water that has been contaminated by the feces of people infected with hepatitis A. 

The hepatitis C virus is present in blood. While it can be transmitted sexually, the rate of sexual transmission is low. Hepatitis C is more likely to be transmitted through the use of shared needles or razors.

To protect yourself from sexual transmission of hepatitis, you can get vaccinated against hepatitis A and B (there is currently no vaccine for hepatitis C). Using condoms or other barrier methods during vaginal, oral, or anal sex can also reduce your risk of contracting viral hepatitis as well as other sexually transmitted diseases and infections.

Does hepatitis affect male fertility?

Some hepatitis infections are associated with impaired sperm quality as well as impaired fertility for both males and females.

One study observed the effects of hepatitis B and C on sperm quality parameters such as motility and morphology. Sperm motility and rate of normal sperm morphology were significantly decreased in people who were positive for hepatitis B and C compared to the control group.

Another study found that semen volume, sperm concentration, sperm survival rate, and rate of normal sperm morphology in infertile males with hepatitis B were significantly lower than infertile males without hepatitis infection. People with hepatitis B have also been found to have an increased risk of sperm DNA fragmentation, or damage to the DNA inside sperm, which can contribute to infertility and miscarriage.

Treatments for hepatitis

Treatment plans for hepatitis will vary depending on the type of hepatitis you are experiencing. For example, in cases of non-viral hepatitis, like alcoholic or toxic hepatitis, decreasing exposure to chemicals or consumption of harmful substances are critical to healing. In cases of severe alcoholic hepatitis, a liver transplant may be necessary.

When it comes to viral hepatitis, you may be prescribed injectable or oral antiviral medication to treat the infection. People with hepatitis B and C may see positive results with a medication treatment plan. And in fact, the use of some antiviral medications to clear hepatitis B infection has been associated with an increase in reproductive function.

Then there are other viral infections, like hepatitis A, that don’t have a specific treatment plan. In these cases, prevention measures — such as vaccination — are key to ensuring you don’t contract the hepatitis virus to begin with.

Trying to conceive with hepatitis

People with hepatitis B are 1.59 times more likely to experience infertility than people without the infection. It is by far the type of hepatitis that is most commonly associated with infertility.  The good news is that there are treatment plans for hepatitis B — and the sooner you are diagnosed with hepatitis B and begin treatment, the better.

For those who are trying to conceive, it’s really important to note that hepatitis A, B, and C can be transmitted through unprotected sex. You should treat and clear any hepatitis infection before having unprotected intercourse or trying to conceive with your partner, especially since hepatitis B can be detrimental to female fertility and fetal health.

Hepatitis B can be passed to children during childbirth and cause lifelong illness. A study that observed 407 couples found that babies born to a gestational parent who is infected with hepatitis B have a 90% or greater chance of developing chronic hepatitis B if they do not receive proper treatment at birth. On the other hand, sperm-producing partners did not transfer the hepatitis B virus to their children via conception.

If you have been diagnosed with or treated for hepatitis and want to understand whether your sperm health has been affected, a good place to start is with a sperm analysis. Browse our guides to learn more about how sperm testing works and ways you can improve your sperm health.

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