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Background <p>Male reproductive dysfunction has been reported during the acute phase of COVID-19. However, the long-term patterns in semen quality and hormonal parameters across the extended pandemic and post-pandemic periods, and whether these patterns differ by age, remain poorly characterized. This large-scale, retrospective study was conducted to delineate these trajectories in infertile men.</p> Results <p>Among 90,125 records, normal sperm morphology showed a sustained deficit: the proportion of men with morphology ≥ 4% declined from 88.9% pre-pandemic to 55.1% in Post-Phase 2 (<i>p</i> &lt; 0.001), with nearly half falling below the WHO clinical threshold (4%). Serum testosterone decreased modestly from 4.46 to 4.19 ng/mL (6.1% reduction; (<i>p</i> = 0.006) but remained above the hypogonadism threshold for most men. These alterations persisted two years into the post-pandemic period without returning to pre-pandemic baselines.</p> Conclusions <p>The COVID-19 pandemic was associated with persistent, clinically meaningful deficits in normal sperm morphology and a moderate, non-hypogonadal testosterone suppression, with distinct age-dependent patterns. These findings underscore the need for age-stratified reproductive health surveillance following major population-level stressors.</p>

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Divergent long-term trends in semen quality and reproductive hormones across the COVID-19 pandemic era in infertile men: an age-stratified retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月26日

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  • Peilian Li,
  • Shuang Liu,
  • Ke Chen,
  • Yang Gao

摘要

Background

Male reproductive dysfunction has been reported during the acute phase of COVID-19. However, the long-term patterns in semen quality and hormonal parameters across the extended pandemic and post-pandemic periods, and whether these patterns differ by age, remain poorly characterized. This large-scale, retrospective study was conducted to delineate these trajectories in infertile men.

Results

Among 90,125 records, normal sperm morphology showed a sustained deficit: the proportion of men with morphology ≥ 4% declined from 88.9% pre-pandemic to 55.1% in Post-Phase 2 (p < 0.001), with nearly half falling below the WHO clinical threshold (4%). Serum testosterone decreased modestly from 4.46 to 4.19 ng/mL (6.1% reduction; (p = 0.006) but remained above the hypogonadism threshold for most men. These alterations persisted two years into the post-pandemic period without returning to pre-pandemic baselines.

Conclusions

The COVID-19 pandemic was associated with persistent, clinically meaningful deficits in normal sperm morphology and a moderate, non-hypogonadal testosterone suppression, with distinct age-dependent patterns. These findings underscore the need for age-stratified reproductive health surveillance following major population-level stressors.