Last week on consecutive days the telegraph ran reports about male fertility.

The Impact of Coronavirus on Male Fertility 

The first discussed a publication in the journal Reproduction about a German study suggesting that Covid 19 significantly affected male fertility in hospitalised male patients. This is an important observation, and although this may be an effect specific to this virus, such findings would not be atypical in a group of severely ill men with fever and often low oxygen levels in their blood stream. Moreover when treatments may include steroids and antiviral agents, the possible causative factors may not be clear cut.

Of equal importance may be a more subtle effect of the virus on men with milder symptoms of Covid. There is a theoretical basis for this possibility because the ‘receptor’ to which the virus binds, the ACE2 receptor is widespread in the testicle.

Although I have seen several men who may have been been affected, the good news is that recovery has occurred after six months.

Another reason to be careful and to take the vaccine (which has no adverse effect on fertility) As with so much research, definitive evidence is almost impossible to obtain. To “prove” an effect we would need a large group of fertile men (it would need 2000 or more) and then follow them until some of them had symptoms of Covid, then prove it with a positive test, and then assess their fertility. We would need 50-100 positives, and as the virus recedes, and as younger men are vaccinated, this sort of prospective study becomes increasingly difficult.

Currently there is a large multi central study European study aimed to try to identify the virus and its effects in testicular tissue. This may give us some direct evidence, but will take time.

The Impact of Air Pollution on Fertility 

The other publication from China is probably of equal importance. This report linked male subfertility to air pollution, due to the “particulates’ from carbon emissions. Let’s hope that the world concentrates so hard on carbon neutral initiatives that reduced pollution means that this research will be less easy to verify.

Stay safe, and take the vaccine,

Jonathan Ramsay