Objective: Dexamethasone and favipiravir, an RNA polymerase inhibitor, are utilized in the treatment of COVID-19. This study aimed to evaluate the effects of favipiravir and dexamethasone, both individually and in combination, on ovarian tissue and reproductive function in female rats.

Material and Method: The study included 32 female albino Wistar rats, divided into four groups of eight rats each. The first group served as the control group (SG), the second group received favipiravir (FPR, 100 mg/kg), the third group received dexamethasone (DEKSA, 8 mg/kg), and the fourth group received a combination of favipiravir and dexamethasone (FDA, 100 mg/kg favipiravir + 8 mg/kg dexamethasone). Favipiravir was administered orally twice daily for one week, while dexamethasone was administered intraperitoneally once daily. Serum AMH levels were measured in blood samples. In the ovarian tissue, MDA and tGSH levels were assessed, and histopathological damage and follicle counts were evaluated.

Results: AMH levels were found to be lower in the FPR and FDA groups. The MDA level in the FPR group was approximately twice that of the SG, while the MDA level in the FDA group was approximately six times higher than that of the SG. tGSH levels were similar between the SG and DEKSA groups but were significantly lower in the FPR and FDA groups. The number of primordial follicles in the FDA group was significantly lower compared to the SG group.

Conclusion: It was demonstrated in vivo that favipiravir and/or dexamethasone may negatively affect ovarian reserve by reducing serum AMH levels and the number of ovarian primordial follicles. Additionally, they may cause oxidative stress by increasing the levels of reactive oxygen species and decreasing the levels of antioxidant molecules in ovarian tissue.