Safe Medication with Remdesivir for COVID-19 in Patients with Infertility

SARS-CoV-2, also known as COVID-19, emerged in China in December 2019. SARS-CoV-2 viruses use angiotensin-converting enzyme 2 (ACE2) as a receptor to enter cells. Studies have indicated that SARS-CoV-2 has destructive impacts on spermatogenesis and semen parameters, including sperm count, sperm motility, and sperm morphology. In addition, there is a concern regarding the negative consequences of treatment of COVID-19 with Remdesivir on infertility status. We aimed to investigate the effects of Remdesivir and also COVID-19 on semen parameters in patients with confirmed infertility. The present study included 90 patients aged between 23 to 51 years referring to our hospital between March 2021 and July 2022. All of the patients were diagnosed with primary or secondary infertility, which was confirmed by semen analysis, and also diagnosed with active COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) tests. All patients underwent semen analysis four months after the recovery from COVID-19. Patients who had severe manifestations of COVID-19 received intravenous Remdesivir. The mean age of the study participants was 35.72±6.29 years. Twenty-one patients received Remdesivir for the treatment of COVID-19. The semen parameters, including sperm count, sperm motility, and sperm morphology, were analyzed before and after the development of COVID-19. Our analyses revealed a significant decrease in sperm count, sperm motility, and sperm morphology after the development of COVID-19 compared to the semen analysis results in the pre-disease period (P-value=0.000). We also showed that Remdesivir has a statistically insignificant effect on semen parameters with the P-value of 0.511, 0.408, and 0.940 for sperm count, sperm motility, and sperm morphology, respectively. Although COVID-19 has negative consequences on semen parameters, Remdesivir can be considered a safe medication for the course of the disease.