Impact of Covid-19 vaccination on fertility |
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Impact of Covid-19 vaccination on fertility
Dr Veena Aggarwal, Consultant Womens’ Health, CMD and Editor-in-Chief, IJCP Group & Medtalks Trustee, Dr KK’s Heart Care Foundation of India,  25 January 2022
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A new study published in the American Journal of Epidemiology has suggested that Covid-19 vaccination has no adverse impact on fertility.1

The study recruited 2126 women, aged 21 to 45 years, between December 2020 and September 2021 from the PRESTO (Pregnancy Study Online) study with the aim to investigate the effect of Covid-19 vaccination and SARS-CoV-2 infection, if any, on chances of conception per cycle among couples trying to conceive spontaneously without resorting to fertility treatment. The couples were followed till November 2021.

PRESTO is a non-profit web-based preconception study being conducted at Boston University. The study is looking at the impact of lifestyle factors such as diet, exercise, and medication use on fertility and pregnancy.

Women were instructed to provide answers to a questionnaire related to income,  education level, lifestyle, reproductive history including menstrual cycle history, past medical history, partner information, Covid vaccination status or history of Covid-19 infection, every 8 weeks until they became pregnant, or up to 12 months if they did not.

No significant difference in conception rates per menstrual cycle in either partner were observed between the couples who had been vaccinated (at least one partner had received at least one Covid-19 vaccine dose) or were unvaccinated. The likelihood of conceiving was 1.08 for women and 0.95 for men with at least one dose of the vaccine.

Overall, there was no difference in conception among couples where either partner tested positive for SARS-CoV-2 infection (FR 1.07).

There was no difference in conception rates for couples in which the male partner had tested positive for Covid-19 more than 60 days before a cycle (FR 1.16), compared to those couples where the male partner tested negative for the infection. However, among the male partners, a confirmed infection within 60 days of a given cycle was associated with a reduction in conception rate (FR 0.82), which was short-lived and such couples were 18% less likely to conceive in that particular cycle. The authors hypothesize that the transient decrease in fertility among male partners could possibly be attributed to testicular inflammation and erectile dysfunction following SARS-CoV-2 infection. Also, fever, which is a common symptom of Covid-19, could also play a role in this because of its well-recognised role in impairing spermatogenesis.

Among women, no effect of SARS-CoV-2 infection was found on the chances of conception, whether they had tested positive within 60 days or >60 days of a cycle.

This study shows that Covid-19 vaccination did not adversely affect fertility though a short-term decrease in fertility was noted after male partner SARS-CoV-2 infection. Instead, the vaccination could protect couples, suggest the study authors, particularly women and their unborn children, from the harmful effects of Covid-19 during pregnancy. Hence, physicians should encourage couples who are trying to conceive, to take the Covid-19 vaccine.

Reference

  1. Wesselink AK, et al. A prospective cohort study of COVID-19 vaccination, SARS-CoV-2 infection, and fertility. Am J Epidemiol. 2022 Jan 20;kwac011. doi: 10.1093/aje/kwac011
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