Evaluation of the Effects of COVID-19 Infection and COVID-19 mRNA Vaccine on Ovarian Reserve

Objectives: This study aimed to investigate whether COVID-19 infection or COVID-19 mRNA vaccination affects ovarian reserve and reproductive hormone profiles in reproductive-aged women. Methods: This retrospective longitudinal (before–after observational) single-center study included women aged 16–44 years who presented to a tertiary center between January 2021 and September 2023. Participants either had a confirmed COVID-19 infection by a positive polymerase chain reaction (PCR) test or had received two doses of a COVID-19 mRNA vaccine without prior infection. Women with available ovarian reserve parameters within six months of infection or vaccination were included. Anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), thyroid-stimulating hormone (TSH), total testosterone, and free testosterone levels were evaluated at baseline and reassessed six months later. Menstrual cycle characteristics were recorded. Parametric and non-parametric statistical tests were applied as appropriate. Results: No statistically significant differences were observed in AMH, FSH, LH, E2, PRL, TSH, total testosterone, or free testosterone levels before and after COVID-19 infection or vaccination (all p > 0.05). Comparisons between infection and vaccination groups across age subgroups (<25, 25–35, ≥35 years) revealed no significant differences in ovarian reserve parameters. Menstrual irregularities were reported in 38.0% of women following infection and 18.6% following vaccination. All reported menstrual changes were transient and resolved within six months. Conclusions: COVID-19 infection and mRNA vaccination were not associated with detrimental effects on ovarian reserve or reproductive hormone profiles. Although transient menstrual irregularities were observed, no long-term adverse reproductive impact was detected. Larger prospective studies are warranted to confirm these findings.