Impact of inactivated COVID-19 vaccination on female ovarian reserve: a propensity score-matched retrospective cohort study

Abstract

PurposeTo explore the impact of inactivated COVID-19 vaccination on ovarian reserve as assessed by serum anti-Müllerian hormone (AMH) concentration.MethodsA total of 3160 women were included in this single-center retrospective cohort study between June 2021 and October 2022. Vaccination information were collected from official immunization records available in personal mobile apps. Serum AMH was qualified by electrochemiluminescence immunoassay and compared with previous measurement data within three years. Women were categorized to the vaccinated group if they received two doses of inactivated COVID-19 vaccines (Sinopharm or Sinovac) between AMH tests (n = 488), and to the control group if not vaccinated (n = 2672). Propensity score matching and multivariate linear regression were performed to control for potential confounders. The main outcome measures were the numeric AMH change and percentage AMH change between the two tests.ResultsThere were 474 women left in each group after matching all baseline characteristics. The mean interval from the first to second AMH measurement was 508.0 ± 250.2 and 507.5 ± 253.6 days for vaccinated and unvaccinated women, respectively (P = 0.680). Both groups had a significant AMH decrease in the second test compared with the first test (P = 0.001). However, the second AMH level remained comparable between groups (3.26 ± 2.80 vs. 3.24 ± 2.61 ng/mL, P = 0.757). Similarly, no significant differences were observed in numerical (-0.14 ± 1.32 vs. -0.20 ± 1.56 ng/mL, P = 0.945) and percentage (2.33 ± 58.65 vs. 0.35 ± 48.42%, P = 0.777) AMH changes. The results were consistent in sub-analyses for women aged <35 and ≥35 years. There were also no significant differences when vaccinated women were divided according to the time interval after vaccination: ≤30, 31–60, 61–90, and ≥91 days.ConclusionOur study provides the first evidence that inactivated COVID-19 vaccination has no measurable detrimental effect on ovarian reserve, regardless of female age and vaccination interval. This reassuring finding adds to the safety evidence of COVID-19 vaccine in fertility, and should be useful to promote vaccine acceptance. Multicenter prospective cohort studies are needed to validate our conclusion.

SARS-CoV-2 Vaccines-Related Endocrine Disorders: An Updated Narrative Review

“…In most clinical studies, ovarian reserve markers and semen quality analysis were used as the primary assessment tools in female and male fertility, respectively. The summarized studies that evaluated the potential effect of the vaccines on female fertility registered no significant negative impact on ovarian reserve markers [143][144][145][146][147][148][149][150][151][152][153][154]. Most of these studies were conducted among women undergoing assisted reproduction cycles.…”

“…However, one prospective study described a significant decrease in serum AMH levels at months 3 or 6 of follow-up compared to pre-vaccination. However, at month 9 of follow-up, serum AMH levels normalized and stayed within the normal ovarian reserve range (>1.1 ng/dl) throughout the study period [149].…”

“…The association between SARS-CoV-2 vaccination and ovarian reserve parameters was investigated in twelve studies summarized in Table 2 [143][144][145][146][147][148][149][150][151][152][153][154].…”