While research is still inadequate and does not cover all COVID19 vaccines, it is medical scientists’ opinion that vaccines do not harm male fertility.
We all know the planet is experiencing an unprecedented pandemic known as COVID-19, caused by the SARS-CoV-2 virus, which has killed millions to date. The only solution to defeat the pandemic, at the moment, is vaccination. However, its progress was stalled by the anti-vaccination movement (activists opposed to vaccination and persuading the masses to follow them).
This is a reaction that is based more on fear and belief in “conspiracy theories” that have not been proven, but sound “impressive and scary.” Among such fictions is the theory that vaccines disrupt spermatogenesis and render men infertile.
Why this is just a myth, explains Mr. Vasilis Protogeros, surgeon-urologist-andrologist, associate professor at the School of Medicine of Athens, director of the 5th urology clinic of Metropolitan General.
SARS-CoV-2 and male fertility
The virus, through its protein spike (S-spike), enters cells after first binding to a protein / receptor in human cells, ACE2. The problem is that the male reproductive system has a large number of ACE2 receptors, which makes it vulnerable to the virus. Indeed, many studies have confirmed that men infected with this virus develop orchitis, epididymitis, and prostatitis, as evidenced by histological studies.
Recovered patients were found to have sperm quality abnormalities that could be caused by causes other than damage to the reproductive system, as there is evidence of viral brain damage (leading to a disruption of the hypothalamic-pituitary-testicular axis, which regulates spermatogenesis). In addition, oxidative stress develops, which destroys sperm and disrupts the hormones associated with sperm production. All of these elements raise great concerns about the end point of male fertility in a male infected with the virus.
Vaccines for SARS-CoV-2
The vaccines currently available are supplied by Pfizer, Moderna, AstraZeneca and Janssen. Of these, Pfizer (BNT162b2) and Moderna (mRNA 1273) are mRNA preparations. These vaccines are technology that dates back to the 1990s and is based on the fact that instead of a virus, they inject a ready-made encoding into the body that our body “reads” as a form of mRNA.
The mRNA synthesizes the S-virus protein and thus activates our defenses. The Janssen vaccine (Ad26.COV2.S) is a modern technology from the 1970s and uses inactivated adenovirus 26 as a vector that contains information about S-protein synthesis in its genome. AstraZeneca (AZD1222), the same technology as Janssen, uses a different virus as a vector that also contains S protein information. As soon as the carrier virus enters the body, our body reads the information and synthesizes the S-protein, activates its defense against it. When a real virus enters our body, the S-protein / spike will be destroyed and its communication with our cells will be prevented, and therefore it will die, since by their nature viruses do not live outside of cells.
Vaccines and fertility
What we know about vaccines: Our knowledge is based on research conducted by Pfizer and Moderna in the United States and Israel. In a study with both vaccines, sperm quality was checked before and after vaccination was completed and it was found that there was no difference.
On the contrary, the sperm count increased, and interestingly, of the 8 men who had an abnormal (minimal) count before vaccination, 7 returned to normal. This cannot be explained and is not considered a statistically significant increase in overall sperm count. However, this indicates that there is no negative effect of the vaccine on fertility.
Another study (Pfizer only) found the same results: not a decrease, but an increase (not statistically significant) in sperm count and an improvement in semen quality in men who had abnormally low sperm counts before vaccination.
In addition, a study conducted at an in vitro fertilization center examined the effects of Pfizer vaccination on a male and female couple. It was found that there was no effect on the genetic material of a woman taken for in vitro fertilization, and an increase in sperm count was also observed in men (not statistically proven).
It is noteworthy that while couples had unsuccessful IVF before vaccination, after vaccination in 3 couples out of 36 IVF was successful.
Although the studies are still small and do not cover all vaccines, the picture is that vaccines do not harm male fertility. This is why the Society for Male Reproduction and Urology (SMRU) and the Society for the Study of Male Reproduction (SSMR) recommended in January 2021 that men who should be vaccinated should proceed as usual (get vaccinated) without thinking about their fertility.
Therefore, men who need to be vaccinated can get vaccinated because the vaccines for which there is evidence are safe.
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