Covid-19 has an impact on fertility, really?

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In December 2020, British doctors Michael Yeadon and German Wolfgang Wodarg launched a petition to challenge the European Medicines Agency about potential risks of infertility in women caused by the Covid-19 vaccine. Nevertheless, current data from clinical trials have shown that these vaccines, like all others, have no known adverse effects on fertility in women and men.

Yet some continue to doubt. So, is it possible that there is a link between Covid-19 and infertility? What do current studies recommend for people who want to conceive? Is it contraindicated to get vaccinated if you are undergoing fertility treatment? Canal Détox looks at these important questions.

The impacts of the epidemic on reproductive and sexual health

To date, it has not been demonstrated with certainty that Covid-19 affects the fertility of women from a physiological point of view. For example, according to observations conducted on 237 SARS-CoV-2 positive women of childbearing age in January 2021 (published on the National Library of Medicine), no significant disruption of the menstrual cycle was noted after infection. . In men, an article published in the journal Fertility and Sterility in March 2021 suggests that possible cardiovascular disorders caused by the virus and their treatments in some could lead to erectile and ejaculatory disorders, as well as a transfer to intensive care or resuscitation. However, it is possible that these disorders are related to stress or to the infectious syndrome in general but not to the virus itself. Moreover, this is an isolated scientific article and no other study has, so far, corroborated these observations.

However, this article also pointed out that the risk of premature births or miscarriages increased when the mother or father had been in intensive care because of Covid-19 before the conception of the baby, or during pregnancy in the case of mothers. . This data was also observed in another review article published in February 2021, which showed that the risk of a premature birth during or after infection was on average between 10 and 25% for a pregnant woman infected with SARS. -CoV-2, and went up to 60% if it contracted a severe form of the disease. It is most often premature deliveries artificially triggered in order to be able to better care for the mother.

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In addition, social and psychological factors related to the pandemic may have disrupted the sexual health of the population. A report by the United Nations Population Fund (UNFPA), picked up by The Lancet in April 2020, showed that the prioritization of Covid-19 was disrupting health services related to sexuality, reproduction and fertility. This exposes the least advantaged women to difficulties in accessing contraception and abortion, and hinders the support of future mothers in their pregnancy. As for the number of births, the National Institute for Statistical Studies recorded a 13% drop between January 2020 and 2021, attributed to the pandemic and a feeling of uncertainty among couples about the future, but not to a general decline in fertility.

To date, no impact of the vaccine has been observed on the fertility of men and women

Regarding the link between anti-Covid vaccination and infertility, the data are few but quite reassuring so far. The research teams have focused in particular on the impact of vaccines on the success of infertility treatments.

An observational study [1] published in May 2021, for example, assessed the influence of the mRNA anti-SARS-CoV-2 vaccine on the in vitro fertilization (IVF) process. The researchers studied couples who went through this procedure, before and after the injection of the vaccine. Of 36 couples who resumed the IVF process between 7 and 85 days after receiving the vaccine, no difference was observed in ovarian activity, nor any change in the characteristics of the embryos.

The British Fertility Society recommended in February 2021 that people undergoing infertility treatment (IVF, egg freezing, intrauterine insemination), although they can safely get vaccinated during treatment, take into take into account the potential side effects that may occur a few days after the injection (fever, fatigue, etc.). Thus, it may be more appropriate to wait a few days after vaccination to start or resume fertility treatment, so that side effects of the vaccine are not mistakenly attributed to the effects of the treatment. This is why it is also advisable to have received both doses of vaccine before starting or resuming treatment.

Separately, a study published in Jama Network from June 2021 analyzed semen from a small sample of 45 healthy men before and after injection of the two doses of the mRNA vaccine against Covid. No difference was observed in seminal fluid. It is therefore, to date, not contraindicated to be vaccinated if one wishes to donate sperm, just as there is no contraindication for women wishing to donate their eggs. . Studies on a larger sample and with a longer-term follow-up will be necessary to confirm these observations.

Studies on animal models also provide some leads for evaluating the impact of vaccines on reproductive health. Thus, data showed that the mRNA vaccine tested in 44 female mice had no effect on their reproductive performance, fertility or general ovarian and uterine parameters. Fetal development before and after birth was also normal. These animal models, although less directly applicable to humans, provide reassuring additional data on the effects of the mRNA vaccine.

Read our Detox Channel “Dangerous vaccination for pregnant women, really? »

There is therefore today no evidence or valid scientific theory that would suggest that the Covid vaccine would pose a risk to the fertility of men and women.

The American Society for Reproductive Medicine has stated that RNA vaccines "do not cause an elevated risk of infertility, first and second trimester miscarriage, or birth defects." The US Centers for Disease Control and Prevention (CDC) also confirmed that "for all vaccines, there is no evidence to suggest they cause fertility problems". The risk-benefit balance concerning reproductive health is therefore today in favor of the vaccine. Several clinical trials are now underway to further assess its efficacy and side effects on fertility and pregnancy.

The lack of data concerning the potential impacts of vaccination on fertility also questions the real relevance of this questioning. To date, there is no data on other vaccines that would have a link with reproductive disorders nor any previous scientific hypothesis in favor of a link between these two points. The scientific question seems irrelevant compared to other health issues related to infection by SARS-CoV-2 itself, and explains the fact that the scientific community has not yet mobilized to treat this subject as a priority.

[1] An observational study is a study in which the researcher simply observes the subject without controlling any variables or intervening.

Text written with the support of Professor Olivier Picone (U 1137 – IAME Infection antimicrobials, modeling, evolution – University Paris Diderot)