Effect of SARS-CoV-2 infection and vaccine on ovarian reserve: A systematic review

Eur J Obstet Gynecol Reprod Biol. 2024 Jan:292:63-70. doi: 10.1016/j.ejogrb.2023.10.029. Epub 2023 Oct 27.

Abstract

Objective: To evaluate the effect of SARS-CoV-2 infection and vaccination on ovarian reserve.

Methods: Relevant articles were identified in the EMBASE, PubMed, and Web of Science databases from January 2020 to May 2023. Available clinical indicators of ovarian reserve, such as anti-Müllerian hormone (AMH), antral follicle count (AFC), follicle-stimulating hormone (FSH), and estradiol (E2), as well as the time interval from infection or vaccination to measurements, were assessed.

Results: Only 2 studies provided evidence that SARS-CoV-2 infection could damage ovarian function. In a comparison of the vaccinated and unvaccinated groups, although 1 prospective cohort study observed the transient statistically significant decrease on serum AMH levels at 3 or 6 months of follow-up, serum AMH levels remained within the normal reserve range (>1.1 ng/dl) throughout the study period.

Conclusion: Overall, whether ovarian reserve may be affected by SARS-CoV-2 infection remains controversial and further investigations are warranted to clarify this issue. Based on the current evidence, it is safe to assume that COVID-19 vaccination does not exert any adverse effect on ovarian reserve parameters such as AMH, AFC, FSH, and E2, which will provide reassurance for women attempting to fall pregnant.

Keywords: Anti-Müllerian hormone; Antral follicle count; COVID-19 vaccination; Ovarian reserve; SARS-CoV-2.

Publication types

  • Systematic Review

MeSH terms

  • Anti-Mullerian Hormone
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Female
  • Follicle Stimulating Hormone
  • Humans
  • Ovarian Follicle
  • Ovarian Reserve*
  • Pregnancy
  • Prospective Studies
  • SARS-CoV-2

Substances

  • COVID-19 Vaccines
  • Follicle Stimulating Hormone
  • Anti-Mullerian Hormone