Abstract
BACKGROUND: An association between the coronavirus disease 2019 (COVID-19) and a reduction in male semen parameters has been described, but no large-scale population analyses have been conducted. This study aimed to investigate the effects of the COVID-19 pandemic on semen quality. Based on a large-scale ecological comparative study, our study analyzed the impact of the COVID-19 pandemic on semen quality after the national liberalization of restrictions in China at the end of 2022, aiming to explore the impact of the COVID-19 pandemic on semen quality, and provide a basis for the study of the impact of subsequent epidemics on male reproduction as well as clinical diagnosis and treatment. METHODS: It is a population-based cross-sectional study. This comparative study was based on the nationwide loosening of COVID-19 curbs in China on December 7, 2022, 1 month after which, an 89% infection rate was reported in Henan Province, China. We compared semen quality and serum hormone levels from January 7, 2023 to April 30, 2023 and January 7, 2022 to April 30, 2022 at the Reproductive Center of Henan Provincial People's Hospital. RESULTS: Our results indicated a significant decrease in semen volume, sperm concentration, total sperm count, progressive sperm motility rate, and non-progressive sperm motility rate following the nationwide relaxation of COVID-19 restrictions. The effects on the semen volume and total sperm count persisted over time. Additionally, an increase in the incidence of sperm neck defects has been reported. Infection also led to hormonal disruptions, including alterations in prolactin (PRL), testosterone (T), sex hormone-binding globulin (SHBG), and the free testosterone index (FTI) along with an increase in osteocalcin and 25-hydroxy vitamin D (25-OH-VD). CONCLUSIONS: The present study revealed that mild COVID-19 appears to have a detrimental effect on semen quality.