Effects of Different Drug Therapies and COVID-19 mRNA Vaccination on Semen Quality in a Man with Ankylosing Spondylitis: A Case Report
Katerina Chatzimeletiou,
Alexandra Fleva,
Antonia Sioga,
Ioannis Georgiou,
Theodoros-Thomas Nikolopoulos,
Maria Markopoulou,
Nikos Petrogiannis,
George Anifandis,
Antonios Patrikiou,
Efstratios Kolibianakis,
Anastasia Giannakou,
Grigoris Grimbizis
Affiliations
Katerina Chatzimeletiou
Unit for Human Reproduction, 1st Department of Obstetrics & Gynaecology, ‘Papageorgiou’ General Hospital, Aristotle University Medical School, 56403 Thessaloniki, Greece
Alexandra Fleva
Department of Immunology and Histocompatibility, ‘Papageorgiou’ General Hospital, 56403 Thessaloniki, Greece
Antonia Sioga
Laboratory of Histology and Embryology, Aristotle University Medical School, 54124 Thessaloniki, Greece
Ioannis Georgiou
Laboratory of Medical Genetics, School of Medicine, University of Ioannina and Medical Genetics and Assisted Reproduction Unit, Department of Obstetrics and Gynecology, University Hospital of Ioannina, 45110 Ioannina, Greece
Theodoros-Thomas Nikolopoulos
Unit for Human Reproduction, 1st Department of Obstetrics & Gynaecology, ‘Papageorgiou’ General Hospital, Aristotle University Medical School, 56403 Thessaloniki, Greece
Maria Markopoulou
Department of Immunology and Histocompatibility, ‘Papageorgiou’ General Hospital, 56403 Thessaloniki, Greece
Nikos Petrogiannis
IVF Unit, Naval Hospital of Athens, 11521 Athens, Greece
George Anifandis
Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, 41200 Larisa, Greece
Antonios Patrikiou
Unit for Human Reproduction, 1st Department of Obstetrics & Gynaecology, ‘Papageorgiou’ General Hospital, Aristotle University Medical School, 56403 Thessaloniki, Greece
Efstratios Kolibianakis
Unit for Human Reproduction, 1st Department of Obstetrics & Gynaecology, ‘Papageorgiou’ General Hospital, Aristotle University Medical School, 56403 Thessaloniki, Greece
Anastasia Giannakou
Department of Immunology and Histocompatibility, ‘Papageorgiou’ General Hospital, 56403 Thessaloniki, Greece
Grigoris Grimbizis
Unit for Human Reproduction, 1st Department of Obstetrics & Gynaecology, ‘Papageorgiou’ General Hospital, Aristotle University Medical School, 56403 Thessaloniki, Greece
Background and Objectives: Ankylosing spondylitis (AS) is a condition that affects 0.1% to 0.5% of the adult population. The aim of this case report was to investigate the possible effects of the drugs taken for treatment of AS as well as mRNA vaccination for COVID-19 on semen quality by performing a highly detailed analysis. Materials and Methods: Sperm characteristics were examined by light microscopy, DNA fragmentation (DFI) was analysed by flow cytometry and morphology was evaluated by transmission electron microscopy (TEM). Results: Semen analysis under therapy with (1) celecoxib and sulphasalazine showed: concentration 47 million/mL, 53% progressive motility, 7% normal morphology and 9.6% DFI, (2) Golimumab and before mRNA Vaccination showed: concentration 108 million/mL, 82% progressive motility, 1% normal morphology and 7.6% DFI, and (3) Golimumab and after 3 doses of mRNA Vaccination showed: concentration 142 million/mL, 85% progressive motility, 1% normal morphology and 6.8% DFI. TEM revealed head, neck and tail abnormalities, as well as the presence of cells with incomplete spermiogenesis white cells and phagocytes in the sample under therapy with celecoxib and sulphasalazine. Golimumab treatment lead to an increased incidence of elongated heads but in general reduced inflammation as no white cells were evident in TEM. Conclusion: The anti-inflamatory drugs celecoxib and sulphasalazine had no adverse effect on sperm quality as all parameters were within normal limits and the patient achieved under that treatment 2 pregnancies following natural conception that lead to the birth of a healthy boy and girl respectively. Anti-TNFa treatment with Golimumab exerted a negative effect on morphology but not on concentration, motility and DFI. After 3 doses of mRNA Vaccination, sperm concentration increased while motility, morphology and DFI remained similar to the values before vaccination suggesting no negative effect of the mRNA vaccine for COVID-19 on sperm quality.
