Coveted male fertility what do we know about the coronavirus and its impact on sperm hey friends welcome back today I am talking about covet and sperm I know I focused on this channel a lot on female fertility I've talked about the covet vaccine but I really want to talk about something that I don't think is getting enough attention and that is the impact of getting covet on male fertility to start we don't have any evidence that getting covet impacts female fertility we haven't even seen early pregnancy outcomes what we have seen is late pregnancy outcomes like preterm birth increased hospitalization into bation and death risk for the mom and higher rates of c-section but we've not seen a higher rate of miscarriage or stillbirth we've not seen any impaired fertility if females get copied but we are seeing an impact on male fertility so today I want to review this article semen impairment and occurrence of source code 2 virus and semen after recovery from covid 19. okay so this is a study that we're going to break down and we're just going to do a little lip review really quickly the first thing that's important is we need to understand sperm and eggs are such different i mean obviously they're different but sperm is so different so unlike a woman who is born with all the eggs she's ever going to have and they just run out over time men are constantly regenerating sperms perm is developed in the testes so there are germ cells and sperm developas they grow through the testes over the course of approximately 72 days it then takes around 18 days for the sperm to get from the testes into the ejaculate so sperm has to grow and then it has to be transported to where it's going to go that's about a 90-day lifespan every single day there's different sperm in different stages of development this means that your sperm can be exposed to something and they're very sensitive so let's look at a sperm sperm are really sensitive a sperm has a head which is entire job is to protect some dna and then it has a tail which job is to make it move and so sperm are developed and they are extremely susceptible to the environment and we know this we know that male lifestyle factors can play a role in semen analyses things that can impact sperm parameters can include exposure to toxins like cigarette smoke or marijuana things such as heat so constantly submerging the testes in hot tubs or saunas even maybe riding motorcycles and other health problems such as obesity or high blood pressure or cholesterol and even getting sick so having a recent illness can impair your sperm parameters we've known this for a long time so a good example in history is mumps if you get mumps one of the consequences you're probably going to live and be fine but mumps causes atrophy inside the testes and you can have a zoo spermia no sperm in the ejaculate it can destroy the testicular function so they can no longer make sperm and so you see men who are sterile who have no sperm after having mumps as a child obviously with the invent of vaccines the mmr vaccines as measles mumps and rubella this prevents those from getting mumps we're starting to see mums become irrelevant again as people aren't vaccinating i think this is going to have reproductive consequences later on issue so moms causes this issue called mumps orchietitis where we know that the testes get inflamed and it destroys their cells what about covid so even getting really sick with just a flu we sometimes see drop in sperm parameters but this hasn't really been looked at in covid even though we your reproductive endocrinologist have been saying that we've been observationally seeing this so now we're going to go over this study which is looking at a few different things but the thing i thought was most interesting was how sperm looked in the ejaculate after recovery from covid so the study question how was the seam and quality of sexually active men following recovery from severe acute respiratory syndrome cova2 okay so one fault of this study in my opinion is that there's no control group everybody has gotten hospitalized the control group is men who did not get hospitalized so how i interpret this question is looking at how does the severity of disease impact your semen analysis because your control group was considered normal men who had covet who did not have to get hospitalized what happened to their sperm compared to menuet covedon were hospitalized or hospitalized in the icu so we're really looking at the severity of infection importantly none of this has a control group that's baseline so what is baseline men who don't have covid we're going to use normal semen parameters to compare those two because we have that for normal population-based levels but when we talk about statistical significance understand that they're comparing everybody had coveted in the study so we're not looking at the guy who doesn't have covid this was a prospective cross-sectional study this means that we looked into the future at a subsection of the population which in this case was 43 men small so this is a small n small number we're taking a very small sample size and we're trying to apply those results to the general population it was a biological fluid we looked at semen urine and saliva and these men were known to have recovered so before entry into the test they actually had negative tests first a couple things to note i always like to look at table one table one in any study should be your demographics of your groups and so what we're looking at here is are there major differences between the people who got hospitalized and who are not hospitalized there were in this study and that may impact our results so look at this right here your median year and age so the non-hospitalized was 44 years the hospitalized not in icu was 52 years and the hospitalized in the icu was 59 years this is old i mean we know that men can reproduce older than women this is kind of rubbing it in a little bit but that was statistically different so already the people who are in the icu tend to be older therefore their sperm parameters may be impacted as well and i want to pull attention to this one factor right here period between last negative swab in days all of these are between you know 24 to 37 days so at least a month time has passed before these men had their samples given and when their last negative test was so that was their negative test so presumably at least two to three months from when they were first diagnosed with cova so when we look at semen analyses what are the factors we look at we look at the volume so we look at how much ejaculate there is we look at the concentration how much sperm is per milli liter look at the motility how does the sperm move and we look at the morphology the shape of the sperm so compared to normal i'm going to look at the non-hospitalized group compared to normal there was normal amount of sperm volume normal sperm concentration the motility is low so already we have a low motility in the non-hospitalized group and the morphology is low so com ared to men who have not had covid in our population-based studies we have low motility and low morphology in men who have had covet and now have 30 days from a negative test even if they had a mild infection that did not require them to be admitted to the hospital when we look at the hospitalized and the icu admission we see a change in these you can actually see the sperm concentration goes from 65 million per milli liter in the non-hospitalized group 17.8 million per milli liter in the hospitalized group which is borderline to zero to azuspermia in the icu group the motility significantly drops in the hospitalized in the icu group two you have motility in the 20 where it was 36 percent in the non-hospitalized and 50 is normal and the morphology across the board is low two percent three percent zero percent we like to have at least four percent normal sperm under strict parameters okay here's how i take this data all men who have covet infection in this study 43 of them small sample size had an impairment in their semen parameters from normal even upon recovery from covet of at least a month this is important especially when it comes to motility and morphology of sperm because the sperm's lifespan is three months it usually takes three to six months to see a full recovery of the semen analysis if you're 25 and your female partner has normal anatomy and ovulate then three to six months is probably not a big deal if you're 41 as the female partner trying to get pregnant and you have to wait three to six months to get sperm into the ejaculator to get it normal to get you pregnant that may be closing your door to have a child and you may need to accelerate treatment depending on your own factors or how many kids you want and i think it's really important to know that nobody is talking about also if you have a severe case of covet you may actually have a zoospermia no sperm in the ejaculate that's not just a low chance of getting pregnant that's a no chance of getting pregnant take home messages coping and pack sperm parameters likely will return back to normal but i don't have this data yet i am not anticipating these severely ill men have covid go asospermic and never get sperm again although we need that study to prove that that's happening but just in clinical practice that's not what we're seeing however getting covet even a non-hospitalized infection may lead to detrimental sperm parameters specifically motility and morphology and severe infections impair concentration as well as motility morphology this may have significant implications if you're trying to get pregnant so summary if you've had covet or you get coveted you're trying to get pregnant you should consider getting a semen analysis that you can understand what you're working with talk to your fertility doctor we may change your treatment plan number two specifically if you're trying to get pregnant in the near future or right now and you're eligible for the coveted vaccine please go get it not getting covet is the best thing you can do if you're a man for your fertility at the current point there is no evidence that the cova vaccine impairs sperm production in any way there's not even a hypothesis that that's happening there's not even a fake facebook post so that would exist so there should be no reason stopping you from going to get that specifically if you're really trying to conceive a child thank you guys so much for listening hopefully this was a little bit helpful always trying to bring the latest research let me know if you like lit reviews if you want more of them let me know other questions you have that i can answer in the comments if you like this please subscribe to the channel that always helps me out so much and i really appreciate it as always you can listen to the as a woman podcast for more fertility related information.
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