There have been publications which suggest Covid-19 does affect the testes. So, the short answer would be, yes, male fertility is affected by Covid-19.
By Dr Rohit Gutgutia
In 2019, Covid-19 came into our lives and we are still figuring out how to deal with it. There is a growing concern on how Covid-19 will impact people who are undergoing fertility treatments and planning for a family. Initially, the world thought that Covid impacts only the respiratory system but slowly and steadily it came to our knowledge, with the help of numerous studies, that this deadly virus also seems to be impacting different parts of our bodies as well. With the emergence of new strains, so frequently, researchers are still experimenting and trying to learn more.
There have been publications which suggest that Covid-19 does affect the testes. So, the short answer would be, yes, male fertility is affected by Covid-19. But we need to realise that in other viral infections as well, there could be a temporary effect on the testes. So, we assume that there is a possible complete reversal of the fertility potential, once Covid-19 resolves in the human body. We also know for sure that it induces an inflammatory response in multiple systems of the body. And whenever there is inflammation, there is fever, and other markers of inflammation that are also raised in the body. Now whenever there is fever, the spermatogenesis i.e sperm synthesis within testes decreases by as much as 50 percent. Such a person shall show a poor semen report if he goes for a test as late as three months post the fever episode as it takes as much as 10 -12 weeks for the sperms to mature.
Can the virus damage sperm count?
There is so much we do not know about this virus and this would come under this category. As the second wave hits India, a new concern is that coronavirus might affect fertility and damage the male reproductive system. We need to understand that almost 16 percent of men who undertake vaccination also have concomitant fever, because of which there is a compromise of sperm synthesis. This might lead to a temporary worsening of semen parameters. So, it can be said that Covid-19 affects fertility, but necessarily forever.
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Stress due to Covid could affect male fertility
According to male fertility experts, coronavirus might impact male fertility, although there is no direct evidence recorded by scientists. Many doctors have urged that people who contracted Covid test their fertility as soon as possible. They suspect that it might damage the function of testicles in men and impact the production of sperms/formation of male sex hormones. Depression and stress due to Covid are observed by doctors and it is clear that male infertility may not be affected by coronavirus alone. The stress of medication and isolation can also be the reason affecting sperm count and sexual performance. Because of the stress and the overall hype associated with Covid-19 infection, there could be some amount of dysfunction that might manifest in some people, but with time as stress levels come down, this may also show improvement.
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The extent to which Covid can harm the sperm count is still unknown. There is no evidence that after recovering, men have long-term infertility, but it could impact short-term sperm quality. A study has shown that there is a 50 percent reduction (on average) in sperm count, volume, and motility. Everything is dependent on various factors such as the immunity of the person, weight issues, diet, any underlying health conditions. The impact on the sperm count also depends upon the severity of the infection. If the person’s infection is high or even moderate it might lead to temporary infertility. However, what we still are trying to know is if there is any permanent damage. Normal influenza can also reduce sperm count but in that case, we know that once the person is healthy again the sperm count comes back to normal in a few weeks. Here, we do not know how long it will take to recover. Men with mild cases of Covid do not face a major effect on their fertility. Studies show that 6-7 weeks after men have recovered from Covid, the virus is still present in the testes. It has also been seen that 10-20 percent of men with Covid have experienced testicular pain. Studies also show that most of the male population recovering from this deadly virus proved to have a higher count of white blood cells in their semen, which shows that the semen had been compromised.
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Covid-19 induces an inflammatory response
Experts are urging men with any kind of discomfort to pay a visit to their doctors to check the extent of damage to the sperm count. Doctors have said that wearing a mask is essential especially because even if you do contract Covid, it will hopefully be a mild case and recovery will be quicker. One can never be too careful. Take all necessary precautions, eat healthy, and refrain from going anywhere unnecessary as we do not know the lifelong implications of Covid-19 yet.
(The writer is Medical Director, Nova IVF Fertility, Eastern India.)
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