Evaluation of Male Fertility Potential After COVID-19 Infection

Background: COVID-19 has been associated with multiple systemic complications, including potential effects on male reproductive health. This study aims to evaluate the impact of COVID-19 infection on male fertility by assessing semen quality and hormonal profiles in post-COVID-19 patients compared to healthy controls. Methods: A case-control study was conducted at Al-Azhar University Hospital, New Damietta, involving 76 participants (38 post-COVID-19 patients and 38 healthy controls). Participants were males aged 18–50 years, with the post-COVID-19 group comprising individuals who had recovered from COVID-19 at least six months prior to enrollment. Semen analysis was performed to assess sperm concentration, motility, morphology, and viability. Hormonal assays were conducted to measure Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), and free testosterone levels. Statistical comparisons between groups were performed using Student&#039;s t-test, Mann-Whitney U test, and Chi-square test, with a significance threshold of p < 0.05. Results: Post-COVID-19 patients demonstrated significantly lower sperm concentration (55.76 ± 8.18 million/mL vs. 63.92 ± 7.27 million/mL, p < 0.001), progressive motility (36.14 ± 4.13% vs. 43.59 ± 5.60%, p < 0.001), and normal sperm morphology (40.00 ± 11.00% vs. 64.00 ± 8.96%, p < 0.001) compared to healthy controls. Additionally, hormonal evaluation showed a significant reduction in FSH (3.87 ± 0.72 mIU/mL vs. 4.77 ± 2.02 mIU/mL, p = 0.011), LH (3.33 ± 0.54 mIU/mL vs. 5.77 ± 2.02 mIU/mL, p < 0.001), and free testosterone levels (9.79 ± 0.63 pg/mL vs. 11.20 ± 0.84 pg/mL, p < 0.001) in post-COVID-19 patients. Conclusion: This study provides evidence that COVID-19 infection may negatively impact male fertility by reducing sperm quality and altering reproductive hormone levels. The findings highlight the need for further long-term research to assess the persistence of these effects and potential implications for male reproductive health. Keywords: COVID-19, male fertility, semen analysis, sperm quality, reproductive hormones, andrology.