The Potential Risk of Povidone-Iodine in Sperm Quality: A Case Report
March 2025 | Volume 24 | Issue 3 | e11 | Copyright © March 2025
Published online February 3, 2025
Fei Shi MMa*, Ling Wang MBa, Changying Xing MDa*, Yannan Yang MBa, Yubing Liu PhDa, Yunjing Xue MMa, Sanwei Guo MDb, Ri-Cheng Chian PhDa
aCenter for Reproductive Medicine, Shanghai 10th People’s Hospital of Tongji University, Shanghai, People’s Republic of China
bDepartment of Urology, Shanghai 10th People’s Hospital of Tongji University,
Shanghai, People’s Republic of China
Abstract
To report a rare case of severe oligoasthenoteratozoospermia which seems to be associated with long-term topical povidone-iodine (PVP-I) therapy. A 45-year-old man with secondary infertility was diagnosed with mild asthenospermia before undergoing in vitro fertilization (IVF). A repeat sperm analysis (SA) on June 30, 2022, after three months of using compound PVP-I liniment to treat fungal infection under a fingernail and toenail, revealed severe oligoasthenoteratozoospermia. After 77 days of drug withdrawal, sperm concentration, and normal morphology gradually returned to normal, but motility was only partially restored. It seems that the usage of PVP-I has a side effect of causing a decline in sperm quality. Although the exact mechanism of this adverse effect of PVP-I is unclear, men who are in fertility treatment should be informed of the potential risks.
J Drugs Dermatol. 2025;24(3):e11-e13. doi:10.36849/JDD.7342
INTRODUCTION
Compound PVP-I liniment is a widely used over-the-counter dermatology drug indicated in the treatment of fungal or bacterial infections of the skin or nails, in which each milliliter contained 30 mg of PVP-I and 120 mg of aspirin. The auxiliary materials used are glycerin, polyethylene glycol, phenol, ethanol, and povidone K30. PVP-I is a complex of polyvinylpyrrolidone and iodine and its bactericidal component is the free iodine.1 It has the ability to penetrate microorganisms quickly and oxidize proteins, nucleotides, and fatty acids, eventually causing cell death.2 Several adverse effects have been reported for PVP-I, including allergic reactions,3 kidney failure, and hypothyroidism.4,5 No studies, however, have reported an adverse effect of PVP-I on sperm quality. There is evidence in this case report that PVP-I negatively impacts male reproductive function.
CASE
A 45-year-old man and his 37-year-old female partner experienced secondary infertility for 5 years following a spontaneous
