The question of whether COVID-19 affects a person’s ability to conceive has been a significant public concern since the beginning of the pandemic. This concern stems from the virus’s systemic nature, which can impact multiple organs, and from misinformation surrounding the safety of the vaccines. A substantial body of scientific research has investigated the link between the SARS-CoV-2 virus, the resulting illness, and fertility outcomes. Analyzing the data on infection and vaccination separately provides a clearer understanding of the actual risks to reproductive health.
COVID-19 Infection and Male Reproductive Health
The most consistent finding regarding male reproductive health is a temporary reduction in semen quality following a SARS-CoV-2 infection. Studies frequently document a transient decline in sperm concentration, total sperm count, and motility in the weeks immediately following the acute illness. This decline is largely attributed to the body’s systemic inflammatory response, rather than direct viral attack on the reproductive tissues. The fever and widespread inflammation accompanying moderate to severe COVID-19 temporarily disrupt sperm production, known as spermatogenesis.
The testes operate at a temperature slightly lower than the rest of the body, and a sustained high fever can impair sperm cell development, similar to the effect seen with other viral illnesses like influenza or mumps. Evidence suggests the virus may indirectly cause testicular injury through a cytokine storm, leading to orchitis (inflammation of the testicles). While the virus can enter testicular cells via the ACE2 receptor, the resulting damage is primarily due to the body’s inflammatory reaction.
Male fertility effects appear to be short-lived, aligning with the 70-to-90-day cycle required for new sperm cells to mature. Studies tracking men post-infection show that sperm parameters, though reduced in the acute phase, generally return to pre-infection levels within three to six months. The consensus is that COVID-19 infection does not cause long-term, irreversible male infertility.
COVID-19 Infection and Female Reproductive Health
Research into the effects of SARS-CoV-2 infection on female fertility has focused on ovarian function and menstrual cycle regularity. Many women who contracted the virus reported temporary disruptions, including changes in cycle length or flow. These changes are commonly linked to the stress, weight fluctuations, and systemic inflammation experienced during the acute illness, which temporarily interferes with the hormonal signals regulating the cycle.
Concerns that the virus might damage the ovarian reserve (the total supply of a woman’s eggs) have been alleviated by studies monitoring anti-Müllerian hormone (AMH) levels. AMH is a reliable biomarker for ovarian reserve. Most research comparing women before and after COVID-19 infection found no significant long-term adverse changes in AMH levels, even among those undergoing in vitro fertilization (IVF).
Studies tracking IVF outcomes in previously infected women showed that the number of retrieved eggs, fertilization rates, and clinical pregnancy rates were comparable to those of uninfected women. While the virus has the potential to access ovarian tissue via the ACE2 receptor, the evidence indicates that any impact on ovarian reserve is minimal.
COVID-19 Vaccination and Conception Rates
The question of whether COVID-19 vaccines affect fertility has led to scientific investigation. Large-scale cohort studies tracking thousands of couples attempting conception consistently found no difference in the probability of conceiving between vaccinated and unvaccinated individuals. These studies demonstrate that the vaccines do not impair female fertility or increase the risk of miscarriage.
The data for men shows no negative impact on semen parameters following vaccination. Studies comparing sperm concentration, motility, and morphology before and after receiving an mRNA vaccine (such as Pfizer or Moderna) found no significant changes. This stability is biologically expected because the vaccines, whether mRNA or vector-based, introduce genetic instructions for the spike protein into muscle cells at the injection site, not into the reproductive organs or germline DNA.
The body quickly breaks down vaccine components after the immune response is generated. The vaccine material does not accumulate or interfere with the process of creating sperm or eggs. The scientific consensus is that the benefits of vaccination far outweigh any perceived risk to fertility.
Current Medical Guidance and Recommendations
Major medical organizations, including the Centers for Disease Control and Prevention (CDC) and the American Society for Reproductive Medicine (ASRM), recommend COVID-19 vaccination for all individuals contemplating pregnancy or who are currently pregnant. Vaccination is advised primarily because infection with SARS-CoV-2 during pregnancy increases the risk of severe illness for the mother and complications like preterm birth.
Individuals should not delay attempts to conceive or postpone fertility treatments based on the timing of their vaccination. Since the vaccines are not live viruses, there is no medical reason to wait a specific period after vaccination before trying to get pregnant.
If a couple has been trying to conceive unsuccessfully for six months or more (if the woman is over age 35) or for one year (if the woman is under 35), a consultation with a fertility specialist is warranted. This advice holds regardless of prior COVID-19 infection or vaccination status, as conception difficulties are most often related to pre-existing conditions rather than the virus or the vaccine.