Does COVID-19 reduce anti-Mullerian hormone levels in women of reproductive age in late periods of infection?

Objective: The question of whether severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection influences ovarian function and oocyte quality has arisen as angiotensin converting enzyme-2 receptors, which facilitates viral infection, are found on reproductive system tissues, including the vagina, placenta, uterus, and ovaries. The primary objective of this prospective study was to evaluate the impact of SARS-CoV-2, on ovarian function, with a focus on anti-Mullerian hormone (AMH) and acute phase reactant levels in patients well after recovery from coronavirus disease-2019 (COVID-19).

Material and methods: This prospective cohort study was conducted in the department of obstetrics and gynecology at a single center between October 2020 and June 2021. In order to investigate the impact of COVID-19 on ovarian reserve, 34 non-pregnant women of reproductive age (24-38 years) with COVID-19 polymerase chain reaction positivity were included.

Results: The difference between AMH levels measured 6 months after COVID-19 infection and baseline AMH levels was -0.31±0.80 ng/dL on average and -0.25 (-2.1-1.3) ng/dL on median. Significant correlations were observed between the change in AMH levels and white blood cell levels (r=-0.434, p=0.010), lymphocyte levels (r=-0.361, p=0.036), C-reactive protein levels (r=0.542, p=0.001), ferritin levels (r=0.570, p=0.001) and procalcitonin levels (r=0.598, p=0.001).

Conclusion: We believe this is the first study to examine whether there is a correlation between the late results of COVID-19 and ovarian function. In this cohort, AMH values decreased 6-months after recovery from COVID-19 and a correlation was found between measures of disease severity and the magnitude of decrease in AMH. However, the study was underpowered and future larger studies are required to validate these findings.