Researchers are beginning to investigate whether COVID-19 can be transmitted sexually. Early data from the study, as well as data from research in China, show the virus is present in some men’s semen.1

But other researchers who studied men who had recovered from COVID-19 did not find virus in semen samples.2 Authors of a new study hope to settle the question and answer questions about the transmissibility in semen.

“This is an ongoing study, and we intend to collect 200 samples,” says Ranjith Ramasamy, MD, associate professor of urology at Miller School of Medicine, and director of male reproductive medicine and surgery at the University of Miami (FL) Health System.

These are the questions investigators want to answer:

  • If the virus is present in semen, is it alive, and can it be transmitted?
  • How long does the virus remain in semen? Does it ever completely disappear?

Researchers will analyze results according to whether the men were symptomatic or asymptomatic when tested, and whether they experienced any symptoms, Ramasamy says.

“We collect samples from them, checking saliva samples and urine samples, as well,” he adds.

Most of the men recruited in the study tested positive after being exposed to COVID-19, or during routine testing. They had not experienced symptoms. “We’re seeing more asymptomatic carriers than we were six weeks ago,” Ramasamy says.

As a precaution while data are collected and analyzed, people with COVID-19 symptoms should avoid any activities that could transmit the virus, including both through droplets and sexual transmission, he suggests.

“The question is with asymptomatic, positive patients,” Ramasamy says. “What percentage of asymptomatic men, who don’t know they have COVID in their blood, have it in the semen?”

It is unknown whether virus in the semen can be transmitted to partners via sexual intercourse. The best advice reproductive health practitioners can give their patients is to recommend using condoms if they are uncertain whether they could be exposed to the virus, Ramasamy suggests.

The New York City Health Department published a three-page guide, titled “Safer Sex and COVID-19.” According to the guide, researchers still have a lot to learn about COVID-19 and sex, but people should take precautions by having sex only with a small circle of consenting partners and taking a break from in-person dates during the pandemic. Their advice also suggests people avoid kissing anyone who is not part of their small circle of close contacts, wear face masks during sex, avoid rimming, masturbate together with physical distance (as much as possible), wash up before and after sex, and wear condoms and dental dams to reduce contact with saliva, semen, or feces. (The guide is available at: https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-sex-guidance.pdf.)

Pregnant women and fetuses also are at risk. “There are case reports of maternal-to-fetal transmission,” Ramasamy says. “For those actively trying to conceive, maybe they should wait a month or two, get tested, and speak with their doctor until we can answer this question definitely.”

Telling patients to use condoms is the best advice physicians can offer, for now, Ramasamy says.

REFERENCES

  1. Diangeng L, Meiling J, Bao P, et al. Clinical characteristics and results of semen tests among men with coronavirus disease 2019. JAMA Netw Open 2020;3:e208292.
  2. Perry MJ, Arrington S, Neumann LM, et al. It is currently unknown whether SARS-CoV-2 is viable in semen or whether COVID-19 damages sperm. Andrology 2020:10.1111/andr.12831. [Epub ahead of print].