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COVID vaccination and male fertility: the evidence

As with all other adverse events we've seen, if you do okay, great, but for those who don't, it's very bad news

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Y Rabinovitz

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June 27, 2022

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COVID vaccination and male fertility: the evidence

Can COVID vaccination impact fertility? All the “fact checks” say: No. But one new study suggests that the correct answer is far more likely to be: Yes.

  • The study found that sperm concentration and total motile count (how well sperm can move) dropped significantly starting between two and four months from the second dose.
  • Virtually all studies claiming to show vaccination does not affect fertility stop two months from the second dose, meaning that they were looking for evidence in the wrong place so didn’t find it.
  • Explaining this effect as similar to that seen after COVID infection is invalid, as multiple studies show that by two months after recovery from COVID, any downturn in sperm parameters has reversed itself.
  • Claims that the study showed “recovery” at around five months post-vaccination are possibly accurate for some trial participants but are certainly grossly inaccurate for at least a quarter of them – their parameters continued to decline, often significantly.
  • Here again, as with other adverse effects from the shots, we see that most people seem to do okay, but those who don’t, suffer spectacularly. Since there was no follow-up, we don’t know if people doing badly at the end of the trial ever recover their sperm counts and motility.

Why study?

Couched carefully, the authors of this new study explain why they conducted their research:

To investigate the effect of Covid-19 BNT162b2 (Pfizer) vaccine on semen parameters among semen donors (SD) ... [because of] the possible impact of Covid-19 on human reproduction.

The possible impact of COVID infection itself on fertility is probably not something you’ve heard much about, because there is very little evidence that COVID has any lasting impact on human reproduction (more about that later), but what the authors went on to say explains the rationale behind this study:

... it was clear [COVID] employs the Angiotensin-Converting Enzyme 2 (ACE2) receptor for cellular entry. Various testicular cells including Leydig, Sertoli, spermatogonia and spermatozoa express ACE2 and related proteases...

What they don’t say outright is that COVID spike proteins attach to these ACE2 receptors. And what they certainly don’t say outright is that the Pfizer vaccine prompts your own body to pump out these same spike proteins. Research has shown that spike proteins are still found in the body two months following vaccination, and studies have shown that spike proteins are found in the male reproductive organs themselves, even though we were all told originally that nothing moved beyond the shoulder muscle injection site. 

Now, what could that mean for the male reproductive organs, these researchers wondered? Let’s see.

Which questions did they answer?

There have been few studies regarding the impact of COVID-19 vaccine of semen parameters, resulting with overall reassuring results; some even reported parameters improving post-vaccination. However, careful examination raises two questions. First, is there a biological rationale for semen parameters improving post-vaccination? Second, since semen analysis may vary significantly over time, what is the reliability of studies that include minimal samples per patient before and after vaccination? In order to answer these concerns, we applied a methodology which will answer two requirements: 1) long term follow up over time with repetitive samples per patient and 2) several statistical analysis approaches which will enable detailed and comprehensive evaluation from different directions.

The first thing to note is that the study’s authors don’t actually address their first concern: “Is there a biological rationale for semen parameters improving post-vaccination?” That’s just an interesting observation as it’s impossible to know why they didn’t address that question.

The second thing to note is that the study’s authors don’t address their second concern either: “What is the reliability of studies that include minimal samples per patient before and after vaccination?” Here, too, it’s a matter of conjecture why they don’t answer that question directly. However, indirectly, the study does indeed answer that question, and the answer is: low reliability. Using a longer follow-up and a larger pool of participants, the researchers found that vaccination lowers sperm count and motility, the exact opposite of what other studies previously showed.

In order to eliminate any concern that the sperm donors might have had COVID which impacted their semen parameters, they were all tested by PCR which came back negative (and re-tested if they showed any suspicious symptoms). Although PCR isn’t a reliable method of testing for COVID infection, the problems are with false positive results, not negative, so it’s safe to assume that these SDs really did not have a COVID infection during the period of this study.

As for the period of the study, it was a big improvement over other studies which only tested up to around two months post-vaccination. This study had four testing points: T0 (baseline pre-vaccination), T1 (15 to 45 days post-vaccination), T2 (75 to 120 days post-vaccination), and T3 (150 days or more post-vaccination).

And now for the findings...

No significant change was demonstrated between T1 and T0. However, while volume and motility changes on T2 were not significant, sperm concentration was significantly lower due to decrease of 15.4% (confidence interval -25.5%--3.9%) compared to T0 (p=0.01). Moreover, TMC [total motile count] percentage change reduction of 22.1% was significantly lower compared to T0 (confidence interval -35% - -6.6%, p=0.007) as well. Although concentration and TMC were reduced also on T3, these values did not reach statistical significance... 

The second analysis focused on median differences ... The only significant changes were found for sperm concentration and TMC with median decline of 12 million/ml and 31.2 million motile spermatozoa, respectively (p=0.02 and 0.002, respectively) during T2 followed by later recovery during T3 (table 3).

Last and similarly, median differences between T1, T2 and T3 vs. T0 according to sample's mean of each donor were investigated. Again, the only significant differences were found specifically on sperm concentration and TMC on T2 – median decline of 9.5 million/ml and 27.3 million motile spermatozoa, respectively (p=0.004 and 0.003, respectively) followed by recovery on T3 (table 4).

(All the underlining is added for clarity.)

Significant decreases in key parameters

The most obviously alarming data here is from T2, between 75 and 120 days post-vaccination. All previous studies looking at the impact of vaccination on sperm parameters stopped before this point, but this study makes it clear that the real impact of vaccination starts here, over two months after the second shot. Sperm counts were down, a lot, and motile count is also significantly down – both these parameters are very relevant to fertility.

Why might vaccination have a delayed effect? The study’s authors suggest that

... rather than [having] a direct effect on testicular cells (via ACE receptor), we believe that systemic immune response is a more reasonable explanation...

 

What about the authors’ claims that there was “recovery on T3”? This is based on median differences. Broadly speaking, using median figures gives an idea of what happens to most people and eliminates the effect of outliers, results that are wildly different from the majority and could have been a fluke or a mistake. The problem with using median figures here is that the outliers are important when deciding if a vaccine has adverse effects on a portion of the population.  We already know that after COVID vaccination, most people don’t die suddenly, but some do. After vaccination, most people don’t develop CJD, but some do. (They die as well.) Most people don’t develop irreversible facial paralysis, but some do (how’s Justin Bieber doing?) 

When you’re testing a new antibiotic, for instance, the effect of the drug is fairly simple and usually, there’s no reason to suspect that a small minority of people are going to react very dramatically to it. In such a case, median figures are useful because they minimize the effect of errors on the final results. But when you’re looking at COVID vaccines, and you already know that a small minority of people truly do react dramatically, for as yet unknown reasons, you want to focus on that minority, not ignore it.

(By the way, that’s exactly what Pfizer, Moderna, the CDC, and the FDC – and others – wanted to prevent you from being able to do, when they refused to risk-stratify vaccination programs and focus on those most vulnerable to COVID. By vaccinating everyone, all the associated dangers become “extremely rare side effects” that most people just dismiss. But if vaccination had focused only on those most at risk from COVID – the elderly, the chronically ill, the obese – the adverse effect profile would have stood out like a black cat on a snowy field, because these are some of the people who often do worse after getting the shot, and also mount the weakest antibody response.)

So, getting back to those medians. 

 

The median difference between sperm concentration at T0 and at T3 in Table 4 (where the results look most favorable for those who want to claim that there was recovery) is 2.5 (which means a decrease of 2.5, slightly confusing, but that’s the way the authors have presented the data). That’s not much, and it’s a lot less than at T2, when the difference was 9.5. However, the 75 quadrantile at that point was 40.2. That means that 25 percent of trial members (those above the 75 quadrantile) had a median difference of more than 40.2, which is certainly extremely significant for them, even if the figures aren’t so significant overall. 

The same is true when we look at total motile count. The median difference at T3 is -6 (i.e. an improvement), but at the 75 quadrantile, that changes to 28.2, which, again, is very significant if you happen to be one of those unlucky people who is particularly susceptible to the effects of mRNA on your reproductive functions.

Furthermore, comparing the outlier at T2 to those at T3 is also instructive. Outliers at T2 had a reduction of over 21.25 for sperm concentration (a lot) which increased to 40.2 at T3. In other words, most people recovered a bit, but those who got a lot worse continued to get a lot worse as time went on. 

The reverse is seen with total motile count. At T2, the outliers were down by 46.1 or more; at T3 they were “only” down by 28.2. So, some people were doing a bit better – maybe all, and maybe not all. It’s impossible to know without access to the raw data (and we already know that we never get that, not from Pharma, not from the CDC, and not from the FDA).

What about COVID?

That’s the favorite argument of the vaccine enthusiasts – sure, maybe there are very, very rare adverse events associated with the shots, but COVID is so much worse! They’re wrong, so let’s just take a moment to demolish this claim with regard to male reproductive parameters.

One of the studies showing the negative impact of COVID infection on sperm parameters is actually cited by the authors of the study we’ve just been looking at. 

Guo et al have recently reported temporary decreased semen parameters (sperm concentration, sperm motility etc.) among 41 patients who recovered from Covid-19 compared to healthy controls 75 days after symptoms' appearance. However, significant improvement was noted among 22 patients who supplied a second sample a month later.

The key phrase is “temporary decreased semen parameters.” A month later, there was “significant improvement,” which is not what we see after vaccination.

The abbreviated citation makes it appear that of the 41 patients, just 22 saw improvement. That’s not accurate, because a glance at the study in question shows that only 22 patients had their parameters sampled for a second time. And all of them saw significant improvement by then. This is exactly what we would expect following any viral infection, in fact – no surprises here.

Other studies have similar findings; for the sake of brevity, I haven’t included them here but they’re easy enough to find.

And then the fact-checkers arrive...

So easy, in fact, that even Reuters, that bastion of mainstream, acceptable news and opinion, couldn’t risk ignoring them. If even Reuters admits that “COVID-19 infection can, at least in the short-term and temporarily,” negatively impact male fertility, then you can be sure that that’s the best they could come up with – given that this is a quotation from a “fact check” designed to disabuse readers of the notion that vaccination could ever be bad for you.

According to Reuters, “Claims that COVID-19 vaccination causes male infertility are still unsupported.” This fact check was published in April, 2022; it’s Reuters’ most recent fact-check on the topic, and hasn’t been updated since. 

Frontline News sent a letter to Reuters Fact Check

With regard to your fact-check on the question of COVID-19 vaccination and fertility, I would like to draw your attention to a very recent study which has been peer-reviewed and published and can be viewed here: onlinelibrary.wiley.com/doi/pdf/10.1111/andr.13209

This study strongly suggests a negative effect on sperm parameters including concentration and motility resulting from vaccination against COVID-19.

Sincerely,

We didn’t get a response. 

Reuters does make a valiant effort to prove its points – that the shots are “safe and effective,” and that COVID itself is the real threat to fertility. Let’s look at the evidence they provide; let no one say that we didn’t present both sides of the argument.

Study One: American Chemical Society

Ten healthy individuals provided the control group; 20 men who had recently recovered from COVID were the study group. Several sperm parameters dropped among the study group, whose members were tested just once, following a 17-day quarantine. No follow-up. 

The authors point out that they failed to control for the after-effects of any viral infection, such as influenza, on sperm parameters. Furthermore, the study group all had “mild-moderate” COVID symptoms and not one member needed antivirals or steroids to make full recovery. Given that COVID vaccination doesn’t even protect against infection and mild disease, and arguably increases the likelihood of contracting COVID, it’s hard to see that this study proves anything at all.

Study Two: Reproductive BioMedicine Online

The study group consisted of 43 male patients undergoing IVF. Authors concluded that, “None of the parameters differed significantly after vaccination.” 

Here, too, the SDs were only tested once post-vaccination, from any time between two weeks after the first shot to a month after the second. No follow-up, and the data is presented as mean figures plus/minus standard deviations, which makes it impossible to know what happened to any outliers.

Study Three: JAMA Network

This is a single-center study involving 45 men, all vaccinated. Their sperm parameters were measured before the first dose and a median of 75 days after the second dose. No further follow-up.

The study’s authors claim to have found “significant increases” in parameters including concentration and TMSC – from 26 million per mL to 30 million per mL (a 15.4% increase) and from 36 million to 44 million (a 22.2% increase) respectively.

It’s important to note that this study used median figures, eliminating the effect of outliers on the data. A look at the single chart included in the online study that doesn’t reduce everything to medians (download PDF to see it) shows that of the 45 men, 12 experienced a reduction in sperm motility. 

Study Four: American Journal of Epidemiology

“COVID-19 vaccination does not affect the chances of conceiving a child, according to a study of more than 2,000 couples ... Researchers found no difference in the chances of conception if either male or female partner had been vaccinated...”

1,369 of the men in the study were vaccinated. Unadjusted data shows a very slight decrease in fertility for vaccinated men. 

More Complaints

In an older Fact Check in which Reuters attempted to debunk the notion that vaccination could harm fertility, they included criticism of a certain Gillian McKeith for writing on Twitter:

They want you to buy into the idea that you don’t have Natural Immunity. But you do!!! You can defend yourself. Nutritional status is important for immunity...

Firstly, lots and lots of people have natural immunity to COVID. That was very nicely demonstrated in a human challenge study conducted in London (see here). The study suggested that as much as 50 percent of the population has natural immunity to COVID.

Secondly, Reuters should be ashamed of themselves for suggesting that a person’s nutritional status has no impact on their health and resilience to disease.

Reuters also quotes Dr. Ying Cheong, a professor of reproductive medicine, who laments the fact that people undergoing fertility treatment are now well-informed enough to ask questions: 

We now have patients insisting to know a donor’s vaccination status...

And they quote Dr. Ramy Abou Ghayda, who claims that

We have enough data and a decent body of scientific evidence at this point that refute any potential negative correlation of COVID-19 vaccines on semen parameters...

Reuters, as we noted, hasn’t responded to the latest study contradicting all their fact checks. But Newsweek did, writing:

Concerns about the COVID vaccines affecting fertility have cropped up a few times over the course of the pandemic ... Much research has been conducted to reassure people that vaccines have no effect on fertility or pregnancy in women.

There have also been studies into whether vaccines affect sperm quality in men, one of which has been widely shared online recently.

Some users expressed concern about the study's results, which appeared to show a temporary decline in sperm counts following vaccination.

As its title suggests, the June 17 study does indeed appear to show that a decline in sperm concentration occurred some months after vaccination in a small group of men who volunteered to participate ... By T3, the reductions seemed to have recovered.

Newsweek added that:

The authors stressed that rather than being concerning, their results “confirm previous reports regarding vaccines' overall safety and reliability despite minor short-term side effects,” and then went on to stress that: 

“... the study is not conclusive despite its apparent findings. Dr. Ranjith Ramasamy, director of reproductive urology at the University of Miami Health System, told Newsweek that he considered the changes observed in the study to be within a normal range.

“Even though the numbers may be statistically significant, I don't think they achieve clinical significance,” he said. “Maybe men who mount a large immune response to the vaccine could have an adverse but temporary impact but larger studies are needed to definitively answer the question.”

Newsweek also quotes Amelia Wesselink, a research assistant professor of epidemiology at the Boston University School of Public Health, who has carried out studies into COVID vaccination and fertility.

Wesselink criticized the study for its small size and for failing to account for other factors that might have caused parameters to change, such as COVID infection – even thought the study ruled out the effect of infection by testing all participants. 

She even claimed that “for COVID infection, there is evidence that damage to sperm can last beyond several months,” neglecting to provide that evidence.

Newsweek then issued its ruling: “Mostly False,” explaining that:

One study does indeed appear to show that a second vaccine dose coincided with a temporary decline in sperm count that later recovered, but it is not a conclusive study and multiple earlier studies had shown the opposite to be true. More research on this topic is needed.

(Underlining added.)

What do the authors say?

Dr. Itai Gat of the Sperm Bank and Andrology Unit at the Shamir Medical Center and Tel Aviv University’s Sackler Medical School, the lead author on the study, was interviewed by The Epoch Times. He is still claiming “overall recovery” after 150 days.

Overall we demonstrate long term safety of the vaccination regarding semen analysis among sperm donors. The temporary decline we found is similar to already known side effects of short febrile illness (ex. flu), followed by later recovery ... It seems that the immune response after vaccination is similar as in cases of common infections which results with short term impairment of sperm production.

Which of course flies in the face of previous data regarding the impact of COVID infection on sperm parameters. And ignores the real concerns raised by the data he himself presents.

And what don’t the authors say?

One question the authors studiously avoided even approaching was: If things look this bad after two doses, what about after three – or more?

Dr. Andrew Bostom of the Brown University Center for Primary Care and Prevention did ask that question (rhetorically), and was suspended from Twitter as a result, for “spreading misleading and potentially harmful information related to COVID-19.”

Bostom had linked to the Andrology study, and then wondered aloud, “Does boostering yield another decline?”

“I kind of understood what they really showed, which is that some of the metrics, whether it was the counts or the motility, were still depressed,” Bostom told The Epoch Times. “And I used their terminology … I didn’t do anything to exaggerate their findings ... the only other thing I put into my tweet [was] that we just don’t know what the effect of boosters is going to be. I don’t know why any of that was such a big deal.”

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