The sperm quality change in 6 months recovery from COVID-19 : a retrospective observational study

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Abstract

XZ and YZ performed the data analyses and drafted the manuscript. NJ, KL and JX participated in data collection. XZ and YZ participated in the design of the study and coordination. ZL and TX had main responsibility for study design, data analyses, data interpretation, and writing the manuscript. All authors read and approved the final manuscript. Background The COVID-19 pandemic has yielded substantial evidence indicating that the virus may possess reproductive toxicity effects and adversely affect sperm quality. Given the sex-specific implications of these findings, it is imperative to reliably assess the reversibility of this damage, determine the precise recovery time, and evaluate male reproductive health parameters post-infection. Methods Male patients who underwent sperm analysis prior to COVID-19 infection were enrolled in a observational trial of changes in sperm quality during 6-month recovery period from COVID-19. Sperm dynamic parameters were collected at five consecutive time points: before COVID-19 infection and at 1, 2, 3, 6 months following infection. Quality of life, psychological status, and sexual function of patients, evaluated with questionnaires, were performed in the first month after COVID-19 infection. The primary outcomes were sperm concentration (Con) and progressive motility rate (PR%). Generalized Estimating Equations (GEEs) was used to perform statistical comparisons on repeatedly measured variables. The Kaplan-Meier survival analysis was employed to observe the trend of the main outcomes over time. Results 1,009 subjects underwent dynamic sperm analysis prior to the widespread of COVID-19, from April 2022 to January 2023. Of 139 eligible patients have completed sperm dynamic analysis in first month after COVID-19 infection, with 92 (66%) patients underwent testing in the second month, 72 (52%) patients underwent testing in the third month, and 64 (46%) patients completed the sperm analysis in the sixth month. Sperm Con [39·22 (95%CI, 32·02–46·41)] and PR [36·41 (95%CI, 3229-40·53)] significantly decreased at first month post-infection compared with pre-infection. Sperm parameters demonstrated a gradual recovery during the following second and third month. At the end of our six-month observation period, the primary outcomes continue to be significantly lower than the levels observed prior to COVID-19 infection. Survival curve analysis indicated that, on average, a duration of 4·37 months was required to achieve an 80% recovery compared to the level before infection. During the first month following infection, no significant adverse impacts were observed on the participants' diverse health scores. Discussion Sperm quality indeed influenced by COVID-19 infection, but temporary, with a recovery period of 4–5 months. Furthermore, no notable alterations were observed in men's psychological, urinary symptoms, or sexual function during the initial month following recovery from infection.

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