Mumps and Male Fertility: What Every Man Should Know

Author : Dr Mike Garside

Mumps and Male Fertility: What Every Man Should Know

Mumps is a virus most of us associate with childhood, swollen cheeks, a few days off school, and not much else. What tends to surprise people is that mumps can behave very differently in a teenage boy or an adult man, and that for a small proportion of men it can have a genuine, if usually temporary, effect on fertility. Over the years I have seen a fair number of men come through the clinic worried about exactly this, often long after the mumps itself has cleared up. This article explains what mumps is, how it can affect the testicles, and what you can practically do about it.

What is mumps and should I be worried about it

Mumps is a viral infection spread through coughing, sneezing and close contact. Since the introduction of the MMR vaccine to the UK childhood immunisation schedule in 1988, mumps has become a relatively uncommon illness, and for most people who do catch it, the infection is mild and self limiting.

The complication that matters for this article is testicular involvement. If mumps affects the testicles after puberty, it is called orchitis, and it is the reason mumps occasionally comes up in conversations about male fertility rather than just childhood illness.

Why mumps cases are appearing again in the UK

Vaccine protection from MMR is very good in childhood, but it does fade somewhat in the teenage and adult years, leaving some people susceptible if they come into contact with the virus again. This matters because uptake of routine childhood vaccinations, including MMR, has fallen to some of the lowest levels seen in over a decade, and both measles and mumps have been circulating more visibly as a result.

The UK Health Security Agency has continued to record mumps cases across England, and the majority of confirmed cases have had no vaccination on record. Outbreaks tend to cluster wherever young adults are mixing closely together, which is why university halls, particularly in the first term of the academic year, are a classic setting for a mumps outbreak.

Symptoms of mumps in men

The hallmark sign of mumps is swelling of the parotid glands, the salivary glands that sit just below and in front of the ears, giving the classic "hamster cheek" appearance. Alongside this, most people experience a general viral illness with:

• Fever
• Headache and general aches
• Fatigue and malaise
• Dry mouth
• Reduced appetite and nausea
• Abdominal discomfort

In post-pubertal boys and men, testicular pain and swelling can also develop, either alongside the facial swelling or a little afterwards. This is orchitis, and it is the part of mumps most relevant to fertility.

What is orchitis and how common is it after mumps

Orchitis is inflammation of the testicle, and it develops in around one in five to one in four post-pubertal males who catch mumps. It usually affects one testicle rather than both, though bilateral cases do happen. Typical features include a painful, swollen, tender testicle, often with a low grade fever returning or worsening as the swelling comes on.

Most cases settle within a week to ten days with rest and simple pain relief. The concern is less about the acute illness itself and more about what can happen to the testicle afterwards.

How mumps can affect male fertility

If a man develops testicular pain or swelling as part of mumps, there is roughly a fifty per cent chance of some visible shrinkage of the affected testicle afterwards, and around a one in ten chance of a reduced sperm count. The mechanism is thought to involve inflammation damaging the delicate tissue where sperm are produced, and in some cases the immune system mistakenly targeting sperm cells once the usual protective barrier around them has been disrupted.

It is worth being clear about what this does and does not mean. Complete infertility as a result of mumps orchitis is rare, particularly if only one testicle was affected, because the unaffected testicle usually continues producing sperm normally. Bilateral orchitis carries a higher risk of a lasting drop in sperm count, which is one of the reasons doctors take it more seriously than a one sided case.

Because sperm take around ten to twelve weeks to fully mature, the fairest way to judge the impact of mumps on fertility is to wait at least three months after the infection has cleared before checking your sperm count. Testing too soon can give a falsely low result that has more to do with recent illness than a lasting problem.

Should you check your fertility after having mumps

If you had mumps as a teenager or adult and remember testicular pain or swelling at the time, it is entirely reasonable to want reassurance, particularly if you are now trying for a baby or thinking about starting a family. A home sperm count test is a simple, private first step. Our ALLTEST SP10 home fertility test checks whether your sperm concentration is above or below the World Health Organisation's threshold of 15 million per millilitre, using nothing more than a sample collected at home and a short wait for the result.

It is a screening test rather than a full diagnostic one, so a negative result is a prompt to speak to your GP rather than a diagnosis in itself. Full details on how the test works, and what a positive or negative result means, are covered on our home male fertility test FAQ page.

Practical steps while you recover

If you currently have mumps with testicular involvement, the mainstay of treatment is supportive care while your immune system deals with the virus:

• Rest: avoid strenuous activity until the swelling and pain have settled.
• Support the area: well fitted underwear or an athletic support can ease discomfort.
• Cold compresses: applied gently, these can reduce swelling and take the edge off the pain.
• Simple pain relief: paracetamol or ibuprofen, following the guidance on the packet, is usually sufficient.
• Isolation: mumps is contagious, so staying away from work, university or school and avoiding close contact with others is important while you are infectious.

Red Flag Warning: Swelling affecting both testicles, a very high fever, or pain severe enough that you cannot walk comfortably should be assessed the same day. These features are uncommon with mumps orchitis and deserve prompt medical attention.

When to see your GP

• You suspect mumps and have not had it confirmed, particularly if you have testicular symptoms
• Testicular pain or swelling develops during or after a mumps infection
• Swelling or discomfort has not started to improve after a week
• You are planning a pregnancy and had significant testicular involvement with mumps in the past

Our when to seek help guide covers the wider picture of when fertility concerns warrant a GP referral rather than home testing alone.

When to seek emergency care

• Sudden, severe testicular pain, which can occasionally indicate testicular torsion rather than mumps and needs same day assessment
• A testicle that becomes hard, very swollen, or discoloured
• High fever with confusion, severe headache or a stiff neck
• Vomiting that prevents you keeping fluids down

What this means for your fertility, symptom by symptom

What you notice	What it usually means	What to do
One sided testicular ache during mumps, settling within a week	Common, low long term fertility risk	Rest, pain relief, monitor
Testicular shrinkage noticed weeks after mumps	Occurs in around half of orchitis cases, sperm production may still be normal	Home sperm count test after 3 months, see GP if concerned
Both testicles affected, or trying to conceive without success	Higher chance of a lasting effect on sperm count	See your GP for full fertility assessment
Sudden severe pain, fever with confusion, or inability to keep fluids down	Possible medical emergency, not typical mumps	Seek emergency care immediately

Monitoring your reproductive health with Access Diagnostics

For most men, mumps is an unpleasant but short lived illness with no lasting consequences. For a minority, particularly those who develop orchitis affecting both testicles, it is a legitimate reason to check in on fertility rather than simply hope for the best. Testing your sperm count at home gives you a quick, private way to know where you stand, and it is a sensible first step before deciding whether further investigation with your GP is needed.

Access Diagnostics has been supplying trusted home health tests and home fertility tests across the UK for over two decades, founded and run by doctors. If mumps, or anything else, has left you with questions about your fertility, our range of male fertility test kits is a straightforward place to start.