COVID and fertility: Can coronavirus or COVID vaccines affect your chances of getting pregnant?

COVID-19 has been found to cause issues in various parts of the body, not just the lungs. The liver, immune system, and reproductive system can also be affected if you catch coronavirus.

Although research is still limited on the topic, scientists have found that catching COVID-19 appears to impact male and female fertility. New studies suggest these effects are temporary rather than permanent. There’s also no evidence that COVID-19 vaccines impact fertility.

Let’s dive into the latest data.

COVID and female fertility: The facts

In March 2021, scientists in Wuhan, China, found that catching COVID-19 might interfere with female fertility, causing some women’s menstrual cycles to become irregular. In some cases, COVID was found to also decrease markers of fertility by affecting 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 is a lot of ACE2 in the ovaries, uterus, and vagina. They play an important role in our cycles by, for example, picking up signals to make sure we ovulate regularly or that a fertilized egg develops into an embryo.

COVID-19 might interfere with these signals by harming tissue in the ovaries, reducing egg quality (making it more difficult for them to be fertilized), and damaging cells that are important for reproduction.

In fact, the Wuhan study — published in Frontiers in Medicine — looked at the impact coronavirus has on fertility by monitoring 78 women who had COVID. They found that the virus disrupts female sex hormone levels, such as anti-Mullerian hormone, and also negatively impacts ovarian reserve (the number and quality of eggs in the ovaries) as well as endocrine function via ACE2. The problem may be even worse for those of us with polycystic ovary syndrome (PCOS), as PCOS can already cause issues with hormone levels and fertility.

But, a January 2022 review of COVID-19 and fertility studies found that changes to hormone levels, ovarian reserve, and menstrual cycle length brought on by catching the virus were temporary in most cases.

It’s important to remember that research into COVID and fertility is ongoing, and more studies are needed to determine the long-term impact.

COVID and male fertility: The facts

Several studies have found that catching 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 the amount and concentration per ejaculation, motility (movement), and shape. Catching COVID-19 can impact all of these. Let’s look at the evidence.

A 2020 study published in the journal Fertility Sterility compared the semen of 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 sperm motility than those who had a mild infection or who never had COVID.

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

Yet another study 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% of patients recovering from COVID, all of whom already had at least one child through natural conception. Additionally, 61% 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. Too much luteinizing hormone can also lead to infertility and a lower sex drive.

These studies suggest that men who have caught 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 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 a 60-day study. Research published in the American Journal of Epidemiology in January 2022 also showed that changes to fertility in male COVID patients were short-term and reversible.

Can the COVID vaccine affect fertility?

Lots of people have been wondering if the COVID vaccine poses a risk to fertility — and the short answer is that it doesn’t. Let’s look at the most recent research. 

According to the US 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 until after getting the vaccine. Because there isn’t any active virus in any of the COVID vaccines, you don’t need to worry about getting COVID from the vaccine. You can, of course, still catch COVID after getting your shot.

Research published in the American Journal of Epidemiology earlier this year mirrors this. It found that the COVID-19 vaccine did not affect fertility in male or female participants. 

The CDC also says people who are planning to get pregnant can get the COVID-19 vaccine, and research shows that the COVID 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. You can read all the latest information around getting vaccinated against COVID during pregnancy here.

COVID and fertility: The takeaway

So far, research on COVID and fertility shows that catching the virus may make it more difficult for people to conceive in the short term, but this is temporary. However, this is still a very new topic, and more studies are needed for us to know the real impact over time. What we do know is that there’s no evidence to suggest any COVID vaccines affect fertility.

Experts also say that there are much stronger known risk factors that contribute to infertility, including smoking, drinking, stress, and being overweight. Managing these can help improve your chances of getting pregnant naturally.

If you’ve had COVID and are concerned about your fertility, speak with your doctor or healthcare 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.