The impact of COVID-19 on the ovarian reserve in women

Objective: To investigate ovarian reserve and menstrual function in women with COVID-19 of various severity. Materials and methods: This prospective study analyzed parameters of ovarian reserve (AMH, FSH, and the AFC) and menstrual cycle (cycle length, menstrual duration) in 41 patients before and after COVID-19 disease. The interval between measurements was 6-12 months. Mild and moderate COVID-19 was observed in 31 (group 1) and 10 (group 2) patients. The inclusion criteria were age 18-45 years, preserved menstrual function. Non-inclusion criteria were decreased ovarian reserve before the onset of COVID-19 (AMH<1.2 ng/mL, AFC<5), a history of COVID-19 vaccination, pregnancy and lactation, severe somatic and infectious comorbidities affecting ovarian reserve. Results: In patients of late reproductive age (LRA) (>35 years), COVID-19 was associated with a reduction in ovarian reserve. Furthermore, patients with more severe COVID-19 had a more pronounced decrease in AFC. When simultaneously assessing the effect of infection severity and age on ovarian reserve, it was found that LRA patients with a more severe form of infection had the biggest decrease in ovarian reserve. The menstrual cycle did not change significantly. Conclusion: The study findings reflect the impact of both age and severity of COVID-19 on ovarian reserve in women. In women of LRA, a decrease in ovarian reserve can occur spontaneously, and the time difference can be very significant. Therefore, one cannot accurately state that ovarian reserve reduction was due to the disease. Nevertheless, the effect of infection severity on the degree of ovarian reserve reduction suggests an adverse effect of SARS-CoV-2 on ovarian function in women.

COVID-19, SARS-CoV-2, COVID-19, SARS-CoV-2, novel coronavirus infection, ovarian reserve, menstrual function, reproductive health, anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), antral follicle count (AFC)