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COVID and Fertility: Can Coronavirus or Vaccines Affect Your Chances of Getting Pregnant?

Researchers are continually gathering new information on the novel coronavirus behind the pandemic. Recent evidence shows that COVID does affect fertility in both males and females. Read Flo’s article to learn what the experts have to say about COVID and infertility.

Even though several small studies suggest there is a link between COVID-19 and fertility, there is no definite answer or proof that it can cause infertility. Further research is still needed.

COVID-19 has been found to cause issues in various parts of the body. In addition to the respiratory system, the liver and nervous, immune, and reproductive systems can also be affected by COVID-19.

Although research is still limited on the topic, scientists have found that COVID-19 appears to negatively impact both male and female fertility. But it’s not yet known if these effects are temporary or long term.

New evidence from a study by Ting Ding and colleagues in Wuhan, China, suggests that COVID-19 may interfere with female reproductive functions, causing irregularities in the menstrual cycle in addition to fertility problems. In some cases, this coronavirus decreases markers of fertility by attacking the ovaries and disrupting sex hormone levels.

Let’s go over exactly how this happens. ACE2 is a cell receptor that COVID-19 uses to enter the body. There are lots of ACE2 located on the ovaries, uterus, and vagina to regulate ovulation, change endometrial tissue, and influence embryo development. So COVID may interfere with female fertility by harming ovarian tissue, reducing egg quality (making it more difficult for them to be fertilized), and damaging cells that are important for reproduction.

The study by Ting Ding, published in Frontiers in Medicine, observed 78 female patients who had COVID. They found that the virus disrupts female sex hormone levels and negatively impacts ovarian reserves and endocrine function via ACE2. This problem may be even worse for people diagnosed with polycystic ovary syndrome (PCOS), as PCOS already causes issues with hormone levels and fertility.

But again, researchers have only just begun looking into this, and more evidence is needed to determine the impact of COVID on female fertility and ovary function over time.

Several studies have found that COVID might cause temporary male infertility. This is due to the way the virus affects semen quality, making it less likely for sperm to be able to fertilize an egg. Sperm health is determined by amount and concentration per ejaculation, motility (movement), and shape. COVID-19 can impact all of these.

Let’s take a look at the evidence. A 2020 study by Holtmann and colleagues, published in the journal Fertility Sterility, compared semen between 20 men who had COVID and 14 who didn’t. They found that men who needed to be hospitalized due to COVID had significantly lower sperm concentration, sperm per ejaculation, and motile sperm than those who had a mild infection or who never had COVID.

A March 2021 study by Maleki and Tartibian, published in the journal Reproduction, confirmed these findings. Sperm concentration and mobility were reduced by 516 percent and 209 percent, respectively, and shape was changed by 400 percent in COVID patients.

And another study, conducted by Honggang Li and colleagues and published in EClinicalMedicine, looked at samples from patients who died or were recovering from COVID and compared them to healthy men of similar ages. They found a lower sperm concentration in 39 percent of patients recovering from COVID, all of whom already had at least one child through natural conception. Additionally, 61 percent of recovering patients had increased white blood cells in their semen, another thing that weakens sperm.

COVID has also been found to impact male reproductive hormones, decreasing testosterone and increasing serum luteinizing hormone levels. Low testosterone can make it more difficult to get an erection and affect sperm development. And too much luteinizing hormone can also lead to infertility and a lower sex drive.

This means that males who have gotten coronavirus have lower chances of fertilizing an egg — in other words, their fertility is decreased.

While this may be concerning, it’s important to note that it’s not yet known how long these effects will last, and researchers are still studying the topic.

In response to the March 2021 study mentioned above, Neel Parekh, MD, a urologist from the Cleveland Clinic, said that the negative impact on sperm may also stem from treating the virus with steroids or antiviral therapies. Jamin Brahmbhatt, MD, President of the Florida Urological Society, notes that semen health improved over the course of the 60-day study, so we can’t yet draw conclusions about future fertility or pregnancy rates.

Many people have been wondering if the COVID vaccine poses a reproductive risk. According to the U.S. Centers for Disease Control and Prevention (CDC), there’s no evidence that any vaccines, including the COVID-19 vaccines, cause fertility problems. They say that if you’re trying to get pregnant, you don’t need to wait to conceive after getting the vaccine. Because there isn’t active virus in any of the COVID vaccines, you don’t need to worry about getting COVID after getting the vaccine.

According to the CDC, people who are planning to conceive can get the COVID-19 vaccine, and research shows that the COVID-19 vaccines do not cause issues during pregnancy. On the other hand, COVID-19 itself has been proven to cause pregnancy complications, and pregnant people have a greater risk of becoming severely ill if they get COVID.

So far, research on COVID and fertility shows that the virus may make it more difficult for people to conceive. But this is still a very new topic, and more studies are needed for us to know the real impact over time.

Experts also say that there are much stronger known risk factors that contribute to infertility, including lifestyle choices, being overweight, and excess stress. Quitting smoking, reducing alcohol consumption, and managing stress can also help improve fertility naturally.

If you’ve had COVID and are concerned about your fertility, speak with your health care provider. Keep in mind that there are lots of fertility tests and ways to boost your fertility, along with advanced fertility treatments to help you get pregnant.

Holtmann N. et al. “Assessment of SARS-CoV-2 in human semen-a cohort study.” Fertil Steril, vol. 114, no. 2, Aug. 2020, pp. 233-238, doi: 10.1016/j.fertnstert.2020.05.028, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256599/

Khalili, Mohammad Ali et al. “Male Fertility and the COVID-19 Pandemic: Systematic Review of the Literature.” World J Mens Health, vol. 38, no. 4, Oct. 2020, pp. 506-520, doi: 10.5534/wjmh.200134, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502312/#B32

Li, Fangyuan et al. “Impact of COVID-19 on female fertility: a systematic review and meta-analysis protocol.” BMJ Journals, vol. 11, no. 2, https://bmjopen.bmj.com/content/11/2/e045524

Ding, Ting et al. “Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study.” Front. Med., 19 Mar. 2021, https://www.frontiersin.org/articles/10.3389/fmed.2021.635255/full

Masson, Dr. Puneet. “The Truth About Testosterone and Male Fertility.” Penn Medicine, 09 July 2015, https://www.pennmedicine.org/updates/blogs/fertility-blog/2015/july/the-truth-about-testosterone-and-male-fertility

“Luteinizing Hormone (LH) Levels Test.” MedlinePlus, 17 Dec. 2020, https://medlineplus.gov/lab-tests/luteinizing-hormone-lh-levels-test/

“COVID-19 Vaccines While Pregnant or Breastfeeding.” Centers for Disease Control and Prevention, 16 June 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html

Li, Honggang et al. “Impaired spermatogenesis in COVID-19 patients.” EClinicalMedicine, vol. 28, 23 Oct. 2020, https://www.thelancet.com/action/showPdf?pii=S2589-5370%2820%2930348-5

“Pyospermia.” Cleveland Clinic, 23 Nov. 2020, https://my.clevelandclinic.org/health/diseases/15220-pyospermia

Miller, Janel. “COVID-19 reduces fertility in men, study suggests.” Healio, 29 Jan. 2021, https://www.healio.com/news/primary-care/20210129/covid19-reduces-fertility-in-men-study-suggests

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