Background: The protective effects of inactivated COVID-19 vaccines against SARS-CoV-2-associated semen impairment remain underexplored. We investigated associations between BBIBP-CorV vaccination and the semen quality in males recovering from SARS-CoV-2 infection.

Research design and methods: This single-center retrospective cohort study included 1,496 males recovering from SARS-CoV-2 infection at a tertiary hospital in Urumqi, China (February-May 2023). Participants were categorized into long-term and short-term effects groups based on the interval between semen collection and their most recent SARS-CoV-2 infection. The study assessed the association between the different doses of BBIBP-CorV vaccination and semen quality in both groups.

Results: A total of 1496 participants were recruited for the short-term (n = 307) and long-term effect groups (n = 1189). Participants had a median age of 32 (IQR: 30, 35). Compared to unvaccinated controls, 2-dose and 3-dose recipients showed reduced short-term semen quality impairment risks, with adjusted RR of 0.945 (95% CI 0.918, 0.973) and 0.965 (95% CI 0.937, 0.993), respectively. No significant results were found for long-term effect groups.

Conclusion: Inactivated COVID-19 vaccination may protect against semen quality impairment among males recovering from SARS-CoV-2 Omicron infection within 90 days, especially in terms of semen volume and sperm progressive motility.