Semen quality changes during infection and recovery phases of mild-to-moderate COVID-19 in reproductive-aged patients: a prospective case series.

Background: Despite the documented effects of the coronavirus disease 2019 (COVID-19) on spermatogenesis, the reversibility of these effects is uncertain. We aimed to assess the changes of sperm quality between the infection and recovery phases of COVID-19 in reproductive-aged men. The semen quality of men with mild-to-moderated COVID-19 (defined by the degrees of symptoms and chest involvement on computed tomography) was studied during October, 2020-May, 2021 at our hospital. Two semen samples were analyzed at timings estimated to represent spermatogenic cycles during the infection and recovery phases of COVID-19.

Results: A total of 100 patients were included with mean ± SD (range) age of 24.6 ± 3.3 (21-35) years. During infection, 33% of patients had abnormal semen quality. However, a significant reduction was found in this abnormality from 33 to 11% (P < 0.001) after recovery from infection. In a comparison of the two semen analyses, there were significant improvements in the mean values of sperm progressive motility (P =0.043) and normal morphology (P < 0.001). However, the mean sperm concentration showed a statistically insignificant increase (P = 0.844).

Conclusions: In reproductive-aged patients with mild-to-moderate COVID-19, the effects on seminal quality were recoverable, represented by significant improvements in the means of progressive sperm motility and normal morphology between the infection and recovery phases of COVID-19.

Trial registration: ClinicalTrials, NCT04595240 .