The effect of Covid-19 vaccines on semen parameters of patients undergoing infertility investigations: a self-controlled before-and-after study.

COVID-19 vaccination faced significant hesitancy among adolescents and men of reproductive age due to concerns regarding its potential impact on male fertility. This study aimed to compare semen parameters before and after SARS-CoV-2 vaccination. We conducted a self-controlled before-and-after study that included patients referred to the Reproductive Biology Department of Monastir for semen analysis within a 3-month interval before (T1) and after (T2) COVID-19 vaccination. Patients who underwent medical or surgical treatment that could influence sperm parameters between the two compared semen analyses were excluded. Sperm parameters were analyzed by the same trained technician and interpreted according to the 2021 WHO guidelines. The study included 48 patients with a mean age of 40.4 ± 7.7 years. A total of 22 patients received an mRNA vaccine, 15 patients received a viral vector vaccine, and 6 patients received an inactivated vaccine. Viability (p = 1), progressive motility (p = 0.240), total motility (p = 0.762), and sperm morphology (p = 1) were similar before and after vaccination. We observed a decrease in semen pH (p = 0.012), and an increase in sperm concentration (p = 0.026) after vaccination. Analysis of the different vaccine subgroups showed no alteration in sperm parameters. According to WHO criteria, qualitative analysis revealed no clinically meaningful alterations in all semen parameters (p > 0.05). The results of this study support semen parameters stability after SARS-CoV-2 vaccination and provide a starting point for reassuring adolescents and men seeking fertility regarding their reproductive potential after vaccination.