摘要：
目的：评估COVID-19灭活疫苗接种及感染对育龄男性精液参数的影响，为男性生殖健康管理提供循证依据。方法：回顾性纳入2020年12月至2023年2月就诊于复旦大学附属妇产科医院的685例男性，分为三组：未接种疫苗组（n=210）、完成三剂灭活疫苗接种组（n=245）、接种后感染组（n=230）。依据WHO 2021标准分析精液体积、精子浓度、活力及形态等参数，采用SPSS 27.0进行统计学分析。结果：疫苗接种组与未接种组在精子浓度（62.24vs.53.81million/mL，p=0.12）、前向运动精子比例（37.11%vs.42.69%，p=0.08）上无显著差异；感染组精子浓度（44.94 million/mL）及总活力（45.44%）显著低于未感染组（p<0.01）。结论：灭活疫苗对男性精液质量无显著影响，但新冠病毒感染可导致精子浓度和活力下降，提示疫苗接种对生殖安全具有保护意义，而感染后需加强生育力监测。

关键词：新型冠状病毒；疫苗；精液质量

Abstract:
Objective: To evaluate the impact of COVID-19 inactivated vaccination and SARS-CoV-2 infection on semen parameters in reproductive-aged males, providing evidence-based guidance for male reproductive health management. Methods: A retrospective analysis was conducted on 685 males who visited the Obstetrics and Gynecology Hospital of Fudan University between December 2020 and February 2023. Participants were categorized into three groups: unvaccinated (n=210), fully vaccinated with three doses of inactivated vaccine (n=245), and post-vaccination infection (n=230). Semen volume, sperm concentration, motility, and morphology were analyzed according to WHO 2021 guidelines, with statistical analysis performed using SPSS 27.0. Results: No significant differences were observed between the vaccinated and unvaccinated groups in sperm concentration (62.24 vs. 53.81 million/mL, p= 0.12) or progressive motility (37.11% vs. 42.69%, p= 0.08). However, the infected group exhibited significantly reduced sperm concentration (44.94 million/mL) and total motility (45.44%) compared to the uninfected group (p < 0.01). Conclusion: COVID-19 inactivated vaccination demonstrates no significant adverse effects on semen quality, whereas SARS-CoV-2 infection leads to marked declines in sperm concentration and motility. These findings underscore the protective role of vaccination in reproductive safety and highlight the necessity for enhanced fertility monitoring post-infection.

Keywords: COVID-19; Vaccine; Semen Quality

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