A Prospective Cohort Study of COVID-19 Vaccination, SARS-CoV-2 Infection, and Fertility

Abstract

Some reproductive-aged individuals remain unvaccinated against COVID-19 due to concerns about potential adverse effects on fertility. We examined the associations of COVID-19 vaccination and SARS-CoV-2 infection with fertility among couples trying to conceive spontaneously using data from an internet-based preconception cohort study. We enrolled 2,126 self-identified females residing in the U.S. or Canada during December 2020-September 2021 and followed them through November 2021. Participants completed questionnaires every 8 weeks on sociodemographics, lifestyle, medical factors, and partner information. We fit proportional probabilities regression models to estimate associations between self-reported COVID-19 vaccination and SARS-CoV-2 infection in both partners with fecundability, the per-cycle probability of conception, adjusting for potential confounders. COVID-19 vaccination was not appreciably associated with fecundability in either partner (female FR=1.08, 95% CI: 0.95, 1.23; male FR=0.95, 95% CI: 0.83, 1.10). Female SARS-CoV-2 infection was not strongly associated with fecundability (FR=1.07, 95% CI: 0.87, 1.31). Male infection was associated with a transient reduction in fecundability (FR=0.82, 95% CI: 0.47, 1.45 for infection within 60 days; FR=1.16, 95% CI: 0.92, 1.47 for infection >60 days). These findings indicate that male SARS-CoV-2 infection may be associated with a short-term decline in fertility and that COVID-19 vaccination does not impair fertility in either partner.

An immunoPET probe to SARS-CoV-2 reveals early infection of the male genital tract in rhesus macaques

“…It is known that SARS-CoV-2 infection in humans is associated with oligo- and azoospermia and a transient decrease in fertility after infection 36, 38, 66, 68, 71, 72 . One study found that fertility amongst infected men was reduced and returned to baseline 3-6 months after SARS-CoV-2 infection 73 . This decrease in fertility was not seen in infected women or men who received a SARS-CoV-2 vaccination.…”

A Case of Asthenozoospermia Following COVID-19 Infection

“…The COVID-19 pandemic has been associated with several health consequences pertaining to many bodily organs from the lungs to the brain, to others [ 1 , 2 ]. Even though it is well established that the COVID-19 vaccine is safe for reproduction [ 3 ], there have been a lot of theories pertaining to the fact that COVID-19 infection itself could impact male fertility [ 4 ]; however, data confirming this hypothesis are lacking.…”

How has COVID‐19 affected sex and fertility?

“…40 A prospective study of 2126 women in North America who wished to become pregnant showed that neither infection nor vaccination had any effect on rate of conception per menstrual cycle. 38 There are problems in pregnancy due to COVID-19 that are beyond the scope of this article. It is, at least, reassuring to find that in the first trimester the viability of the fetus in women with COVID-19 is no different to that in uninfected women.…”

“…A transient fall in the conception rate has been shown in a prospective study of infected men. 38 More data are required to confirm this effect.…”