Abstract
Background: Despite the finite reproductive lifespan of women, the effect of Coronavirus disease 2019 (COVID-19) on female fertility is not widely evaluated, especially in the post-COVID recovery period. Objectives: The study aimed to detect COVID-19's long-term impact on ovarian reserve and menstruation in reproductive-aged women. Methods: One hundred and three reproductive-age women were recruited for this observational study from March to September 2022. Participants with a history of severe COVID-19 were included in the case group (n = 50), while those with non-severe or no infection were considered the control group (n = 53). The ovarian reserve was assessed using anti-Müllerian hormone (AMH) levels, and a structured questionnaire was used to evaluate menstrual cycle abnormalities. Results: We detected a significant decrease in the ovarian reserve indicator, AMH serum levels, in women with severe infection compared to controls (2.66 ± 1.95 vs. 3.38 ± 2.59 ng/L P = 0.03) in the post-COVID-19 recovery period. Characteristics related to menstrual cycle length and volume abnormalities, such as hypermenorrhea and hypomenorrhea, were similar in cases and controls (P = 0.79, P = 0.64), but the severity of dysmenorrhea was significantly higher in cases than controls (P = 0.02). Menstrual pain perception was not related to women’s marital status (r = 0.10, P = 0.27), employment (r = 0.16, P = 0.10), education (r = 0.11, P = 0.24), or AMH serum levels (r = 0.03, P = 0.74). Conclusions: This investigation sheds light on the potential long-term effects of severe COVID-19 on the ovarian reserve and menstrual cycle, which may lead to changes in female reproductive physiology. Longitudinal studies with larger sample sizes are needed to confirm the long-lasting fertility issues in women affected by severe COVID-19.