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January 13, 2022

Sperm testing after COVID-19: the latest recommendations

When the COVID-19 pandemic began in 2019, there were many unknowns about the virus. Initially, experts believed that COVID was primarily a respiratory illness. We’ve since discovered that the SARS-CoV-2 coronavirus can impact other areas of our bodies as well.

There is a growing concern about how COVID may impact fertility. Does getting COVID-19 damage sperm quality? Can the virus be transmitted via sperm? Should you do a semen analysis after you've had COVID? Couples who want to start a family may be grappling with these questions and more. 

Key takeaways:

  • Current research shows that COVID-19 may affect male fertility in the short-term, up to 2–3 months following infection.
  • Therefore, it's recommended that you wait 2–3 months after recovering from COVID-19 before testing your sperm for most accurate results.
  • Scientific studies show that the COVID-19 vaccine does not affect sperm quality or fertility.

How does COVID-19 impact sperm quality?

Based on recent studies and what we currently know about similar illnesses, the COVID-19 virus — known as SARS-CoV-2, a coronavirus — seems to have temporary effects on sperm quality.

Although the research about COVID-19 and male fertility is still limited, here's what we know:

A 2021 meta-analysis looked at 5 studies measuring the change in semen parameters after a COVID-19 infection. The analysis measured several parameters:

  • Semen volume: According to the meta-analysis, men who had previously had COVID-19 produced approximately 0.2 mL less semen, on average, than those with no history of COVID.
  • Sperm count: Sperm count and concentration was significantly decreased for those who previously had COVID-19 — an average of around 16 million less than men who had never had COVID. This represented a decrease of about 27%.
  • Sperm motility. Average progressive sperm motility, or the number of sperm that are “swimming” efficiently, in the COVID group was about 8% less than progressive motility in the control group.

One study says that men recovering from moderate cases of COVID have a poor sperm quality and sperm concentration compared to men without the virus, even after up to 54 days post-infection.

Another recent study followed heterosexual couples who were trying to conceive throughout the pandemic. This study found that couples in which the male partner experienced COVID-19 had a lower chance of conception in the following two months, compared to those who didn’t have COVID. This is likely a reflection of the decrease in sperm quality after COVID.

COVID-19 fever and male fertility

The effect of COVID-19 on sperm quality may be related to the fever experienced by many with COVID infection. Fevers can significantly but temporarily impact sperm quality and fertility. The spike in your body's internal temperature can negatively affect sperm production, which is a process that's sensitive to heat. If a person with COVID-19 experiences fever, we can expect sperm quality to drop due to what we already know about fevers and sperm quality.

When a person experiences a fever, they may experience a drop in sperm count, decreased sperm motility, a higher rate of abnormal sperm morphology, and a high level of sperm DNA fragmentation (genetic damage). 

Thankfully, the negative effects of fever on sperm quality usually aren't permanent. The body is constantly producing new sperm. Typically, after fever recovery, sperm quality returns to normal levels after two full cycles of sperm production. This usually takes anywhere from 45 to 58 days. 

How long does it take for sperm health to return to normal after COVID-19?

One study had 84 men with a history of severe COVID-19 take a semen analysis every 10 days after they were discharged from the hospital, in order to monitor the recovery of their sperm health. This study found that sperm count began to improve at 10 days post-recovery, and continued to improve at 60 days post-recovery. They also found that progressive motility started to improve about 30 days post-COVID, and continued to improve after 60 days.

Another study looked at the semen analysis results of men with moderate cases of COVID. It found that semen parameters, including sperm motility and sperm DNA fragmentation, were significantly worse 2 weeks after COVID-19 diagnosis, compared with 4 months later. This suggests both that COVID-19 causes a drop in male fertility, and that fertility can be recovered over time.

Most studies indicate that the decrease in sperm quality following COVID-19 infection may take 2–3 months to resolve. With this in mind, a person's sperm quality may not be optimal while recovering from COVID, or for the months following recovery.

If you want to get a semen analysis done, it's best to wait 2–3 months after recovering from COVID-19 for the best results. If you’re undergoing fertility treatment, it may also be a good idea to discuss a past COVID-19 infection with your doctor.

Should I get a semen analysis after having COVID?

In most cases, the sperm quality decrease associated with COVID resolves within a few months. There’s no evidence to suggest that COVID-19 can permanently impact fertility, or that it’s absolutely necessary to test your sperm after COVID infection.

You may want to test your sperm after COVID-19 if:

  • You have planned fertility treatment, such as IVF or IUI, in the next 2 months
  • You planned to freeze your sperm in the next 2 months

Others who may want to consider sperm testing include:

  • Anyone who is trying to conceive, especially if they’ve been trying for 6–12 months or more
  • Anyone who is considering sperm freezing
  • People who have gotten a vasectomy (to confirm it was effective) or a vasectomy reversal (to confirm sperm are recovering properly)
  • Anyone who is just curious about their own fertility health

Legacy’s at-home sperm testing kit allows people to assess their fertility without leaving home and risking exposure to COVID at a lab or doctor’s office.

Does the COVID-19 vaccine impact fertility?

No, it does not. There is good evidence to suggest that the vaccine does not affect fertility.

One study that measured sperm parameters in healthy men before and after taking the COVID-19 vaccine reports that there were no significant decreases. Interestingly enough, the study found an increase in sperm parameters after vaccination.

The aforementioned study that followed couples who were trying to conceive through the pandemic also looked at vaccination status. They found that there was no difference between conception rates for vaccinated couples, couples with one partner vaccinated, or unvaccinated couples.

In a joint statement from the Society for Male Reproduction and Urology (SMRU) and the Society for the Study of Male Reproduction (SSMR), it was stated that the COVID-19 vaccine should not be withheld from men desiring fertility who meet regular criteria for vaccination.

To see the numbers firsthand, you can choose to get your sperm tested at home before and after vaccination to get an accurate read of your sperm health and fertility.

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Planning a family during the COVID-19 pandemic

We're learning more and more about the coronavirus every day. The good news is that currently, science shows that COVID-19 likely doesn't have long-term effects on fertility, and the COVID-19 vaccine does not negatively impact fertility.

Sperm testing is the best first step you can take to understand your fertility. Just remember to wait 2–3 months before testing if you are recovering from the coronavirus or have recently experienced a fever. At-home sperm analysis kits can help make this important step in the family-planning process easier during a time of stress and unknowns, and when home-based care is more important than ever.

To learn more about planning a family during the pandemic, read our research-based guide on male fertility and COVID-19.

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