Key Takeaways:
- COVID-19 may impact male hormones, but long-term effects on fertility remain unclear.
- ACE2 receptors in the testes raise concerns about potential viral impact on reproductive tissue.
- Semen analysis can be considered after recovery, though results may lack a pre-infection baseline for comparison.
It can be frustrating for a man when he is trying hard to have children with his partner without success. According to estimates, infertility in males accounts for around a third of all infertility cases.
Coronavirus Male Fertility
There are multiple reasons why men might be unable to have children of their own. More recently, researchers in China have added the coronavirus to possible causes. Their findings suggest that men who recover from the virus may need to seek fertility testing. What do other experts have to say about this? Continue reading to learn more.
Potential Coronavirus Effects on Male Reproductive Health
In February 2020, a group of researchers reported a possible link between the COVID-19 virus and male fertility. This was due to one of the receptors they observed that the pathogen uses to penetrate human cells.
The particular receptor they centered their attention on is called angiotensin-converting enzyme 2 (ACE2). This was believed to have also played a role in the incidence of severe acute respiratory syndrome (SARS).
Studies have shown that people with the coronavirus exhibit abnormal renal function in some cases, apart from respiratory symptoms. There could even be kidney damage.
Based on the foregoing, the researchers developed an interest in finding out whether the virus will also impact the urinary and reproductive systems in males.
Therefore, using online data sets, the scientists looked into the expression of ACE2 in different organs in humans. This led to the discovery that the receptor was highly expressed in kidney and testis cells. Specifically, there was high expression in renal tubular cells as well as Leydig and seminiferous duct cells in the testis.
These findings prompted the Chinese scientists to theorize that the coronavirus could harm patients’ kidney and testicular tissue. They, therefore, advised that health professionals should pay attention to testicular lesion risk in male patients.
However, it doesn’t appear that the study involved male patients with COVID-19.
Theoretical Conclusion
Some other experts said there’s no significant, verifiable evidence yet that the coronavirus impacts reproductive systems. They noted that it was unproven that the pathogen is present in the testes.
This was more in response to the Chinese study published online.
The ACE2 expression study appeared on the website of the Hubei province government but was later taken down. However, it was shared widely on social media in China before its removal. It is also still accessible via the medRxiv website.
Professor Allan Pacey, a renowned male fertility expert at the UK’s University of Sheffield, described the paper as “highly theoretical.” He told Newsweek that it merely raises a topic for discussion or investigation by the scientific community.
“At present, it is somewhat premature to conclude from this study [that] COVID-19 will definitely affect male fertility,” Pacey said at the time, “but it is useful that the authors have raised this concern so that researchers can in due course take a look at the fertility of those who were infected by COVID-19.”
It is worth noting that medRxiv, where the study appeared, does not usually provide peer-reviewed content. The website reports medical research that is awaiting evaluation before being used in clinical practice.
Assessing Male Fertility
Although the said research is yet to be evaluated, it will not hurt for men who have the coronavirus to consider checking their fertility status.
Professor Richard Sharpe, another leading fertility expert working at the University of Edinburgh, hinted at how the coronavirus might impact fertility. He told Newsweek that the elevation of body temperature that pathogens cause can harm sperm production.
In another preliminary study, Chinese researchers found hormonal changes in men infected with COVID-19. These included elevated luteinizing hormone (LH) and a reduced ratio of testosterone to LH, which could suggest temporary effects on gonadal function. However, the study was small and not peer-reviewed, so more research is needed to confirm any long-term impact on male reproductive health.
Infected men showed significantly higher levels of luteinizing hormone compared to healthy controls. However, their testosterone-to-luteinizing hormone ratio was lower, as was the follicle-stimulating hormone-to-luteinizing hormone ratio — both of which could signal disrupted hormonal balance.
Pacey advised that male COVID-19 patients who are worried about their fertility should discuss it with a doctor. A simple semen test might help them figure out whether there is a problem with their reproductive system.
However, the downside to semen analysis, in this case, is that there may not be reference readings. It is less likely that the affected men would have undergone fertility testing before getting infected. Therefore, it would be hard to tell if the virus is responsible for any irregularity.
The fertility expert suggested that semen analyses may help more researchers study a large population. It will be easier to assess a potential link using them in such a scenario.
Semen analysis is the most common technique for assessing male fertility. However, there are other tests available if you are a man looking to know the state of your reproductive system. They include sperm agglutination test, acrosome reaction test, and testicular biopsy, among others.
However, Sharpe told Newsweek that men worried about their fertility status should rather focus on their health. Ensuring that body heat is kept in check could help prevent a problem in this regard, according to him.
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FAQs
Can COVID really affect male fertility?
Possibly. A few small studies suggest it could mess with sperm or hormone levels, but nothing is proven yet.
What did the Chinese study actually find?
It found high levels of ACE2 receptors, which the virus uses, in the testicles. That raised red flags, but they didn’t test actual COVID patients.
Was there any real evidence?
Another study showed that OVID-positive men had lower testosterone and hormone imbalances. It’s early data, but concerning.
Does COVID infect the testicles directly?
No proof yet. The theory is based on where the virus might bind, not confirmed infections in testicular tissue.
Why would sperm quality change after COVID?
High fevers, inflammation, and stress from illness can all hit sperm production hard, even without direct infection.
What tests can check fertility?
Start with a semen analysis. If needed, follow up with hormone panels or a urologist visit.
Why is a baseline test helpful?
Because if you didn’t test before getting sick, it’s hard to know if COVID changed anything.
Should every guy who had COVID get tested?
No — just if you’re trying for kids and want peace of mind, or if something feels off.
Is it permanent?
We don’t know yet. Some damage might be short-term, but that’s why longer studies are needed.
What can men do now?
Stay healthy, manage fevers if sick, and talk to a doctor if fertility is a concern. Testing can’t hurt.
Bottom Line
While no definitive proof yet links COVID-19 to male infertility, some studies raise concerns worth monitoring. Men recovering from the virus, especially those planning to start families, may consider a semen analysis or fertility consultation. However, testing alone may not be conclusive without prior baseline results. The priority should be overall health and minimizing fever or stress that could impair fertility. Further research will help clarify if COVID-19 has any long-term reproductive effects.
References
Gander, K. (2020, February 20). Chinese scientists raise concerns over potential link between coronavirus and male fertility. Newsweek. https://www.newsweek.com/chinese-scientists-coronavirus-male-fertility-1488235
Fan, C., Lu, W., Li, K., Ding, Y., & Wang, J. (2021). ACE2 expression in kidney and testis may cause kidney and testis infection in COVID-19 patients. Frontiers in Medicine, 7, 563893. https://doi.org/10.3389/fmed.2020.563893
Ma, L., Xie, W., Li, D., Shi, L., Mao, Y., Xiong, Y., Zhang, Y., & Zhang, M. (2020). Effect of SARS-CoV-2 infection upon male gonadal function: A single center-based study. bioRxiv. https://doi.org/10.1101/2020.03.21.20037267
