A man with Herpes Simplex Virus (HSV) can have a baby, and the process can be managed safely with modern medical guidance. HSV-1 and HSV-2 are common, and an infection does not prevent a man from fathering a healthy child. The focus shifts to managing the risk of transmission to the female partner and protecting the newborn. Couples planning a pregnancy must work closely with healthcare providers to implement strategies that minimize the risks involved.
Impact of HSV on Male Fertility
For most men, an HSV infection does not interfere with conception. The virus typically resides in nerve cells and does not impact overall fertility. However, some studies suggest a link between HSV DNA in seminal fluid and certain semen characteristics.
Research indicates that HSV infection may be associated with reduced sperm count and diminished sperm motility. This effect is thought to be related to the virus inducing inflammation or triggering antisperm antibodies. Despite these findings, the association is not universal, and HSV is not considered a primary cause of male infertility for the majority of infected men. Couples experiencing difficulty conceiving should undergo a full semen analysis and consult a fertility specialist to determine if sperm quality is a factor.
Transmission Risks to the Female Partner
The primary risk is the transmission of the virus to the female partner, especially if she is HSV-negative. Transmission can occur even when no visible sores are present, a phenomenon known as asymptomatic viral shedding. The virus replicates silently on the skin surface, which is responsible for the majority of new infections.
For couples where the male partner has HSV-2 and the female partner does not, the risk of transmission can be significantly lowered. Once-daily suppressive antiviral therapy, such as valacyclovir, reduces the risk of transmission to the susceptible partner by approximately 48%. Consistent use of barrier methods, such as condoms, further reduces this risk by acting as a physical barrier. Abstinence from sexual activity during periods of active outbreaks remains a foundational precaution.
Protecting the Newborn from Neonatal Herpes
The most serious concern related to a parent’s HSV status is the risk of neonatal herpes, a rare but severe infection in infants. This condition is most often acquired during vaginal delivery when the baby passes through the birth canal of a mother who is actively shedding the virus. The father’s role is to prevent transmission to the mother, ensuring her safety, which in turn protects the baby.
The risk of transmission is highest—up to 60%—if the mother acquires a primary HSV infection late in the third trimester. This is because her body has not had time to produce and transfer protective antibodies to the fetus. If the mother had HSV before pregnancy or acquires it early, her pre-existing antibodies cross the placenta, providing significant protection and lowering the transmission risk during delivery to less than 2%. Standard medical protocol involves examining the mother for active genital lesions at the time of labor; if lesions are present, a Cesarean section is recommended to bypass the infected area.
Medical Management Strategies for Couples
Successful and safe conception begins with comprehensive pre-pregnancy planning and communication with healthcare providers. The first step for any discordant couple is serology testing for the female partner to determine her HSV status, which guides the management plan. If the female partner is already HSV-positive, the risk of transmission to the infant is inherently low due to her existing antibodies.
If the female partner is HSV-negative, the male partner should begin daily suppressive antiviral therapy, such as valacyclovir, to reduce viral shedding and protect his partner during conception attempts. The couple must avoid unprotected intercourse during any active outbreaks. Throughout the pregnancy, coordinated care ensures the mother is monitored closely for any signs of infection. If the mother has a history of recurrent genital herpes, she may be prescribed suppressive antiviral medication starting at 36 weeks of gestation to minimize the chance of an outbreak at the time of delivery.