We delve into 3 COVID-19 studies to break down what impact COVID-19 has on male fertility, whether you should worry, and what to do if you are.
COVID-19 has been battering humanity for more than 2 years now, and reports are emerging on COVID-19’s ability to negatively impact male fertility.
While no evidence has been found supporting claims of testicular swelling or impotence in men who have taken the COVID-19 vaccine, as Nicki Minaj so famously tweeted , there have been more than a few studies published that point to the disease’s potential to lower your chances of getting pregnant.
Now before you panic, know that at the time of writing, there is no definite conclusion as to COVID-19’s effect on male fertility, and whether these effects are permanent.
In this article, we’ll be reviewing 3 of these studies for what they actually said, whether there is any cause for concern, and also what to do to help improve your fertility if you’ve had COVID-19.
What’s the link between COVID-19 and male fertility?
We’re used to thinking of COVID-19 as a respiratory disease, one that primarily affects the respiratory tract and the lungs. That is accurate and true in the vast majority of cases.
However, like with any pathogen, COVID-19 has the ability to circulate throughout the body, infecting various sites. As you may already know, viruses need to get into a living host cell in order to make more copies of themselves. COVID-19 does this by binding to ACE2 , a receptor on the surface of the host cell.
Now, because the virus can and does circulate throughout the body, it therefore also has the potential to bind to and hijack cells in other parts of the body. COVID-19 overwhelmingly prefers cells with ACE2 and will thus infect bodily organs that have a high number of such cells.
So, can you guess besides the lungs, where else in the male body can you also find a high number of cells with ACE2 receptors on their surfaces?
That’s right — in the testicles. This is why we are seeing reports surface about COVID-19 attacking the testes, and the implications it may have for male reproductive health.
3 studies published on COVID-19 and male sexual health
COVID-19 and sperm count 
Autopsies performed on 6 COVID-19 positive men revealed that 3 had impaired spermatogenesis. Further electron microscopy revealed the presence of COVID-19 virus in the testis tissue of 1 of them.
Spermatogenesis is the process by which healthy and functional sperm cells are produced by the body. Hence, this study seems to suggest that COVID-19 can affect sperm production.
Should you be worried?
Firstly, the sample size is really small. In total, only 9 individuals were included in the study — 6 tested positive and 3 others who tested negative were included for control.
Secondly, correlation is not causation. There are many factors that could affect spermatogenesis, including lifestyle factors such as obesity, smoking and being sedentary. As such, we don’t know for sure that COVID-19 causes lower sperm count.
COVID-19 and sperm quality 
A group of 120 Belgian men who caught COVID-19 were evaluated for sperm motility and sperm count up to 3 months after recovery.
The participants’ age ranged from 18 to 69 (median age: 34.7). 8 of the study participants reported having had fertility problems prior to the study, and 5 of the study participants had previously been hospitalised for COVID-19. Otherwise, the cohort was largely in good health.
The study found that 60% of the participants had lower sperm motilities on average during the first month after having COVID-19. This lowered to 37% of the participants up to 2 months after infection, and further reduced to 28% of the participants after more than 2 months.
In terms of sperm count, 37% had reduced average sperm count during the first month after infection. Up to 2 months after infection, 29% of the men still had lowered sperm counts. However a marked improvement was seen beyond the 2-month mark — only 6% of men still showed lowered sperm count.
Should you be worried?
While this study does seem to raise some worrisome implications, others have pointed out that the results could have been skewed due to the use of corticosteroids and antiviral therapies in treating COVID-19 .
Other complicating factors included obesity, of which several of the men in the study were noted to have. In any case, the negative effects seem to be temporary, at least for the vast majority of men in the study.
On a related note, this study also didn’t find evidence of COVID-19 in the semen, which means there’s little to no danger of transmission via this route.
COVID-19 and sex drive in men 
A report accepted for publication in the journal Clinical Infectious Diseases observed that COVID-19 infection could cause testicular damage and lowered sex drive in men.
The study, led by Professor Yuen Kwok-yung of the University of Hong Kong, found a sharp drop in serum testosterone and sperm count 4 to 7 days after infection.
There was also inflammation, degeneration and death of testicular tissue up to 120 days after infection. Although the subjects of the study were male hamsters, the findings highlight the need to check for hypogonadism and low sex drive among male COVID-19 patients.
Should you be worried?
Well, on one hand, it’s a hamster study.
But on the other hand, if you’ve been tested positive for COVID-19 and are not feeling your usual frisky self, this study suggests it might be a good idea to bring it up to your doctor.
Tips to reduce the sexual health impact of COVID-19
Pay attention to your diet
Given the possibility that COVID-19 could affect sperm quality and production, making sure you’re eating a diet rich in nutrients that support testicular and sperm health is more important than ever, especially if you’re trying for a baby.
In particular, Co-enzyme Q10 (CoQ10) has been found to promote sperm production and motility, while also protecting against oxidative stress .
CoQ10 is naturally produced in the body, but you can also top-up levels of this important micronutrient by adding various foods such as organ meats, fatty fish, broccoli, strawberries and pistachio nuts to your plate .
Check your testosterone and nitric oxide levels
If you’re concerned that your sex drive isn’t what it seems after a bout of COVID-19 (or even if you hadn’t been infected) it’s advisable to check your testosterone levels.
This can be quickly done with a finger prick test, or in conjunction with other lab work that requires blood to be taken (hey, since you’re going to bleed, might as well go for a thorough check, right?)
COVID-19 infection may impair testosterone production, which will lead to a whole host of nasty side effects such as low mood, reduced energy, and dampened libido . All these can make getting pregnant much more difficult.
On a related note, you’ll also want to make sure you have healthy nitric oxide (NO) levels, which plays an important role in determining the strength and quality of your erections .
NO is indirectly produced by the endothelial cells, which some studies have found to also be affected by COVID-19 .
Hence, if your morning wood (an important marker of cardiovascular health, by the way) has been lacking after a positive COVID-19 result — even if you’ve had no symptoms — you might be lacking in NO .
Give your swimmers a little help
After ejaculation, sperm has to keep on swimming and swimming until it finally meets up with the egg. You can give your swimmers a little help on their momentous journey by helping them stay on course.
Our Sperm Guide (S$68, £43), made of 100% medical-grade silicone, is designed to safely and comfortably increase sperm retention in the vaginal tract. That way, you’ll have more swimmers staying in the race, improving your chances of fertilisation should a recent COVID-19 infection temporarily suppress your sperm count.