While there's no evidence any of the COVID-19 vaccines cause problems with fertility, becoming severely ill from the disease has the potential to do so, reproduction experts say, making vaccination all the more important.

"There is evidence to suggest that infection with SARS-CoV-2 has the potential to impact both male fertility, female fertility, and certainly the health of a pregnancy of someone infected," said Dr Jennifer Kawwass, a reproductive endocrinologist and associate professor at the Emory University School of Medicine in Atlanta.

"And there is simultaneously no evidence that the vaccine has any negative impact on male or female fertility."

Researchers have been studying the effects of COVID-19 on the human reproductive system since the beginning of the pandemic.

While there's no evidence that COVID-19 can be sexually transmitted, research suggests that the cells in the reproductive system are feasible targets for the virus, because they carry some of the receptors the coronavirus must bind to in order to enter cells.

The idea that a virus could cause infertility is not unprecedented.

"We do have historic evidence that there are certain viruses that are more likely to impact either male or female fertility," Kawwass said.

For example, human papillomavirus (HPV), hepatitis B, hepatitis C and HIV infections have all been linked to decreased fertility.

It's unclear, however, if a respiratory virus, like the coronavirus, could have the same effect.

But the fact that male and female reproductive organs have the receptors the COVID-19 virus targets means it's certainly plausible that the virus could cause fertility issues, she said.

Moreover, the symptoms of COVID-19 — primarily fever higher than 102 degrees Fahrenheit for at least three days — are known to cause fertility issues, especially in men.

According to a recent review paper published in the journal Reproductive Biology, moderate to severe COVID-19 infections have caused decreased sperm count, testicular inflammation, sperm duct inflammation and testicular pain in men of reproductive age.

Although not considered common complications of COVID-19 in particular, these effects are often associated with reduced fertility, and are enough to lead scientists to hypothesize that COVID-19 may cause fertility issues in men, warranting further research in this area.

Dr Eve Feinberg, a reproductive endocrinologist and associate professor at Northwestern University, works with patients with fertility issues every day.

She said although she doesn't think the virus itself directly leads to infertility, she's noticed that some of her male patients have experienced infertility due to low sperm counts after having COVID-19.

"But, it's too early and very hard to say whether or not they had a low sperm count prior to COVID infection," she added.

The symptoms of the disease, rather the virus itself, maybe the culprit when it comes to causing fertility issues.

"Any infection, particularly an infection that involves fever, can affect sperm production and can affect ovulation," said Dr Marcelle Cedars, reproductive endocrinologist and director of the University of California, San Francisco, Center for Reproductive Health.

There's no evidence that COVID would be different from that, she said.

Most of the research on COVID-19 and its effects on fertility have focused on men, but few studies in women have found that neither the virus nor its symptoms seem to have a major impact on menstruation or hormone cycles. Continue reading

In a submission to an Australian parliamentary sub-committee's inquiry, the bishops said it would be "intolerable" to argue "harm minimisation" as justification for commercial surrogacy.

"Children are not commodities and should not be bought," said Bishop Peter Comensoli, the bishops' delegate for life issues.

"Legalising commercial surrogacy would allow the introduction of market values into the intimate and loving role that women have of carrying and giving birth to their child."

The bishops criticised the concept of surrogacy, both commercial and altruistic.

The bishops acknowledged the pain and sadness couples face when they cannot have children because of infertility or the inability to carry a child to full term.

But the bishops pointed out surrogacy can transfer sadness from the infertile couple to the surrogate mother.

"Surrogacy allows for the exploitation of the women who act as surrogate mothers," Bishop Comensoli said.

"It requires a woman to deny many of the significant, integral parts of the experience of pregnancy, which could have a long standing psychological impact on the surrogate mother.

"It gives priority to the childless woman, man or commissioning parents over the woman who is the surrogate mother."

Bishop Comensoli added: "Surrogacy is not undertaken with the priorities and interests of the child in mind, but rather the interests of the adults who want a child."

Bishop Comensoli praised adoption, but said a child should never be produced for the purposes of adoption.

"Surrogacy is different to adoption," he said.

"Where children are adopted by a mother and a father, this matches the model a child should expect of a mother and a father in marriage as a good alternative for when a child cannot be brought up by her or his natural parents."

Sources

• Australian Catholic Bishops Conference
• Image: Emaze

To make this a deliberate choice can make for a bitter and lonely old age, the Pontiff warned at a Mass at his residence at the Vatican on June 2.

Several couples who had been celebrating wedding anniversaries joined him at the Mass.

Preaching on aspects of marriage, the Pope said married couples should be open to new life, just as the Church is fruitful in generating new children in Christ in Baptism.

The Pope said fruitfulness in marriage can sometimes be put to the test, such as when children are ill or when couples have fertility problems.

Couples who deal with infertility or loss can still look to Jesus and "draw the strength of fruitfulness that Jesus has with his Church", the Pope added.

However, "there are things that Jesus doesn't like", he said, such as married couples "who don't want children, who want to be without fruitfulness".

Pope Francis blamed a "culture of wellbeing" for such a choice.

"You can go explore the world, go on holiday, you can have a villa in the countryside, you can be carefree," the Pope said.

"It might be better — more comfortable — to have a dog, two cats, and the love goes to the two cats and the dog. Is this true or not? Have you seen it?" he asked the congregation.

"Then, in the end this marriage comes to old age in solitude, with the bitterness of loneliness."

But Jesus is always faithful, even to those who sin and deny him, and "this fidelity is like a light" that shines on marriage, showing what "the faithfulness of love" looks like, he said.

The Pope's remarks came after Italy's official statistics agency Istat showed the country's birth rate hit a record low in 2013, with the birth of only 515,000 babies — a drop of 64,000 over the past five years.

The previous day, Pope Francis told a charismatic rally in Rome that Satan is trying to destroy the family.

Francis asked God to bless families and to give them strength to withstand the devil's attacks.

Sources

• Catholic Herald
• Daily Mail
• Religion News Service
• Image: Times of Malta

Stuart says the way the news was delivered added to the blow. His doctor walked into the room and bluntly declared: "You've got big troubles. You basically have one good sperm." Stuart says this "made me feel about an inch tall".

Like most illnesses, infertility does not discriminate. But somehow it makes people feel they are part of a brutal natural selection process that prevents the weakest from reproducing their inferior genes. It also has a cruel way of making well-matched couples feel they may not be truly compatible. Says Rachel, "I often think, in a way, that, as hard as it has been, I'm glad it was both of us that had problems because if it was just me, I would have felt as though Stu should go and find someone else."

The Maloneys borrowed most of the $30,000 they have spent on IVF to become pregnant with Nate. While they don't regret a cent of it and believe they have received good care, they still wonder why the often repetitive procedures cost so much. "The thing that always pulls me up is the embryo transfer," Rachel says. "It costs about $3000 and it's a bit like a pap smear. They basically pop a speculum in and use a catheter to squirt the embryo in with some sterile water. It takes about 15 minutes. The doctor is there, so we're obviously paying for his time, but the embryo has already been created and we pay storage fees of about $160 every six months to keep them frozen. A scientist obviously has to prepare the embryos, but $3000 for a 15-minute procedure? That really gets me." Continue reading

Sources

• The Sydney Morning Herald
• Image: The Guardian