COVID-19 disease does not cause ovarian injury in women of reproductive age: an observational before-and-after COVID-19 study

Ilknur Col Madendag, Yusuf Madendag, Ayse Turunc Ozdemir, Ilknur Col Madendag, Yusuf Madendag, Ayse Turunc Ozdemir

Abstract

Research question: Can the SARS-CoV-2 virus injure the ovaries?

Design: An observational before-and-after COVID-19 study at an academic medical centre. A total of 132 young women aged 18-40 were enrolled; they were tested for reproductive function in the early follicular phase, and their information was obtained from hospital data between January 2019 and June 2021. Serum FSH, LH, oestradiol, the ratio of FSH to LH and anti-Müllerian hormone (AMH) concentrations were measured for each patient both before and after COVID-19 disease.

Results: In women with unexplained infertility, the median serum AMH concentrations (and ranges) were 2.01 ng/ml (1.09-3.78) and 1.74 ng/ml (0.88-3.41) in the pre-COVID-19 disease and post-COVID-19 disease groups, respectively. There was no statistically significant difference in terms of serum concentrations of AMH between pre- and post-illness (P = 0.097). Serum FSH, LH, FSH/LH ratio and oestradiol concentrations of the patients before COVID-19 illness were similar to the serum concentrations of the same patients after COVID-19 illness.

Conclusion: According to these study results and recent studies investigating the effect of COVID-19 on ovarian reserve, it is suggested that the SARS-CoV-2 virus does not impact ovarian reserve; however, menstrual status changes may be related to extreme immune response and inflammation, or psychological stress and anxiety caused by the COVID-19 disease. These menstrual status changes are also not permanent and resolve within a few months following COVID-19 illness.

Keywords: COVID-19 disease; Ovarian injury; Ovarian reserve; Reproductive function; SARS-CoV-2 virus.

Copyright © 2022. Published by Elsevier Ltd.

Figures

Figure 1
Figure 1
Box plot of the mean ± SD serum anti-Müllerian hormone (AMH) concentrations of participants both before and after COVID-19 disease.
Figure 2
Figure 2
Serum anti-Müllerian hormone (AMH) concentration differences between pre- and post-COVID-19 measurements.
Figure 3
Figure 3
Log(anti-Müllerian hormone [AMH]) concentration differences between pre- and post-COVID-19 measurements.

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Source: PubMed

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