Covid-19 and fertility: are they correlated?

It is an already unfortunate fact that fertility levels have been falling in many countries. Will they fall more now because of Covid-19 may one ask.. For example, in 2021, Korea’s total fertility rate is projected to fall to a record low of 0.72, said Kwang-Hee Jun, Ph.D., Professor of Demography and Sociology at Chungnam National University in South Korea. This rate is below the 2.1 births per woman demographers consider “replacement level,” which means parents are not having enough children to replace the number of parents in the population. In the United States, the rate fell from 2.1 to 1.6 between 2007 and 2020. Alarming news? Yes, and they are even more alarming now with the Covid-19 pandemic. So many things are happening and no one can predict what the pandemic’s outcome will be for the generations to come. According to the results of MediEmo emotional signature tracking app in 2020 and especially in April, when the pandemic first made its appearance in most countries, emotions such as harm, stress, and the fear of virus fatality had a big rise on patients undergoing IVF treatments. This was mostly because traveling was starting to be prohibited and their treatments were paused due to the pandemic situation. People were scared, misinformed, and hopeless as the virus outbreak was starting to influence all aspects of their lives. In this article, we will try to shed some light on the “myths” and inaccuracies concerning the vaccination, and how Covid-19 affects fertility levels and pregnancy rates. There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men. The fear though and the misinformation that has been raised especially through the media makes couples doublethink the possibility of conceiving. Several cases of women have been followed up after vaccination and showed that those who have received COVID vaccinations have no difference in markers of ovarian follicle (egg) quality compared to unvaccinated ones. Studies have also demonstrated no difference in embryo implantation rate for women who had received vaccination against COVID before having IVF compared to unvaccinated ones. But what about male fertility and covid? Studies have demonstrated no change in sperm volume, concentration, motility (the ability to swim the right way), and total motile sperm count when comparing samples taken before and after COVID vaccination. In cases of pregnant women in Canada and the United States who received the vaccine, minor side effects were similar to non-pregnant adults, and pregnancy complications and baby outcomes were similar to the background rate. Researchers also believe that there are additional benefits of vaccination in pregnancy, with the baby gaining some protection against COVID, more particularly antibodies have been found in cord blood and in breastmilk, suggesting temporary protection for babies (called passive immunity). The science here is clear, vaccination doesn’t affect pregnancy. If you worry about the impact of Covid-19 on your future fertility, science has your back again here. The COVID vaccine induces your body to create an immune response and the components of the vaccine itself are broken down by the body within hours. This means that COVID vaccines don’t stay in your body. After vaccination, you are left with antibodies ready to act in case you get exposed to the virus in the future. There is no link between infertility and miscarriage. But is there something that causes infertility or can hurt pregnancies after all? Yes, the virus itself. SARS-CoV-2, the virus that causes COVID-19, poses a risk for erectile dysfunction and male infertility. While analyzing the tissues of men testicles after being infected with COVID and deceased, researchers from the University of Miami’s Miller School of Medicine discovered some very interesting findings. COVID-19 virus appeared in the tissues of one of the men; decreased numbers of sperm appeared in three. Another patient – who survived COVID-19 – had a testis biopsy about three months after his initial COVID-19 infection cleared up and the biopsy showed the coronavirus was still in his testicles. The team also discovered that COVID-19 affects the penis. An analysis of penile tissue from two men receiving penile implants showed the virus was present seven to nine months after their COVID-19 diagnosis and that both men had developed severe erectile dysfunction, probably because the infection caused the reduced blood supply to the penis. Researchers also suggest that the cells in both male and female reproductive systems are feasible targets for the virus because they carry some of the receptors the coronavirus must bind to enter cells. Other known viruses that affect fertility are HPV, viruses for hepatitis B and C, and HIV. So, it's not uncommon for viruses to attack the reproductive system. Moreover, the symptoms of Covid, primarily fever higher than 102 degrees Fahrenheit for at least three days, are known to cause fertility issues, especially in men. According to a recent review paper published in the journal Reproductive Biology, moderate to severe Covid infections have caused decreased sperm count, testicular inflammation, sperm duct inflammation, and testicular pain in men of reproductive age. Although not considered common complications of Covid-19, in particular, these effects are often associated with reduced fertility and are enough to lead scientists to hypothesize that Covid may cause fertility issues in men, warranting further research in this area. According to recent key messages from the United Nations, fertility levels are destined to return to the previous ones before the pandemic around 2023 and 2025. Especially for European countries, the first wave of the COVID-19 pandemic coincided with a baby bust in most European countries, albeit with significant regional differences. The strongest impact was observed in Southern Europe, while no fertility declines were reported in the Nordic countries. Large fluctuations were observed in the Baltic countries especially Latvia and Lithuania and in Eastern Europe. Provisional data for February/March 2021 point towards weaker downturns and some unexpected upturns. An overall decline in fertility after 2021 appears likely in most countries. Throughout history, pandemics have been a key driver of human population change, due to fear, mortality, and declining fertility rates. The fear of the unknown and the lack of much scientific evidence for the pandemic, lead couples to postpone their parenting plans, although existing scientific evidence suggests the opposite. In addition to the physical health effects of the virus in those infected, the pandemic is also causing detrimental social and mental health effects, which in turn can influence fertility, conception, gestation, and birth. Furthermore, different propagation patterns of the COVID-19 pandemic as occurring in different countries and even in regions within countries may also, in turn, lead to other consequences, the latter related to different socio-economic conditions, healthcare facilities and access, and financial stability. Thus, the impact of Covid-19 on fertility, conception, pregnancy, and birth will likely greatly differ in advanced and emerging economies. Vaccination against the virus is essential if you want to protect yourself, and the most useful thing you can do is consult professionals and stay informed at all times. The one thing that we learned during this pandemic is to trust all those professionals who work for our better future. MEDIPASS is always by your side to guide you through your fertility journey and make it a bit less stressful and frightening. The fertility journey -especially throughout the pandemic era- is not a journey you should do alone. For more information on when, where, and what vaccine you should do you can also visit the national health service (NHS) website of your country. Our cooperating fertility specialists are here to assist your every need.