The long-term impact of COVID-19 infection on semen quality of the COVID-19 survivors

Background. Several studies have shown the short-term effects of COVID-19 on semen quality, but not as many for the long-term effects. This follow-up study aims to explore the long-term effects of COVID-19 on male fertility by comparing semen parameters of patients recovering from COVID-19 infection. Methods. Fourteen subjects aged >18 years old who had a history of resolved COVID-19 infection with previous evidence of laboratory-confirmed positive SARS-CoV-2 nasopharyngeal PCR swab result, and had a previous history of infertility after COVID-19 infection based on the evidence of the semen analysis within 6 months or longer were recruited in this study. Analysis of the semen parameter of all fourteen subjects was performed, including semen volume, pH, sperm concentration, total, progressive, non-progressive, and immotile motility percentage, morphology percentage, leukocyte, erythrocyte, and immature sperm cells parameters. The semen analysis obtained from this current semen analysis was compared with individual baseline semen analysis results, which were obtained in the resolution phase of COVID-19 infection, 6 months or longer from the current semen analysis. Results. Mean pH decreased significantly in follow-up semen analysis, with baseline vs. follow-up 7.9 vs 7.4 (p=0.002; 95%CI=0.3-0.67). Mean sperm concentration also decreased significantly, with baseline vs. follow-up 78.5 million/mL vs. 37.4 million/mL (p=0.013; 95%CI=7.5-74.5). Lastly, mean immature sperm count is also decreased significantly, with baseline vs. follow-up 2.5 million/mL vs. 0.4 million/mL (p=0.006; 95%CI=0.37-4.03). No significant difference was documented for other semen parameters. Conclusion. After 6-7 months of recovery from COVID-19 symptoms, follow-up semen analysis showed reduced sperm pH, sperm concentration, and immature sperm count. These findings indicate that COVID-19 infection could have a longer-term impact on male infertility.