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COVID-19 疫苗接种对生育期妇女月经周期和血清抗苗勒管激素水平的影响。

The effect of COVID-19 vaccinations on menstrual cycle and serum anti-Mullerian hormone levels in reproductive age women.

机构信息

Department of Obstetrics and Gynecology, Celal Bayar University School of Medicine, Manisa, Turkey.

Department of Infectious Disease, Celal Bayar University School of Medicine, Manisa, Turkey.

出版信息

Hum Fertil (Camb). 2023 Feb;26(1):153-161. doi: 10.1080/14647273.2023.2181710. Epub 2023 Mar 15.

Abstract

The aim of this prospective cohort study was to investigate the effect of coronavirus disease 2019 (COVID-19) vaccinations on menstrual cycle and ovarian reserve in reproductive aged-women. Health care providers ( = 258) vaccinated with inactivated (CoronaVac) and mRNA based (Pfizer-BioNTech®) COVID-19 vaccines were included. All subjects completed a gynaecological and menstrual history questionnaire and Anti-Mullerian Hormone (AMH) levels were measured in serum samples collected before first vaccination and at 1, 3, 6 and 9 months. The prevalence of new-onset menstrual dysregulation following vaccination was 20.6% and it was statistically significant compared to baseline ( = 0.001). Menstrual pattern turned back to normal in 59.6% of vaccinated women. Serum AMH levels gradually decreased until 6 month of follow-up compared to baseline ( < 0.001). A significant increase in serum AMH level was observed at 9 month of follow-up compared to 6 month follow-up levels ( < 0.001). The decrease in serum AMH level was statistically significant regardless of serum anti SARS-CoV-2 antibody levels, subgroups of age, occupation, menstrual dysregulation following vaccination and presence of gynaecological diseases. In conclusion, vaccination against SARS-CoV-2 causes a transient decrease on serum AMH levels and moderate irregularities in menstrual pattern increasing with age and is mostly reversible.

摘要

这项前瞻性队列研究的目的是调查 2019 冠状病毒病(COVID-19)疫苗接种对生殖期妇女月经周期和卵巢储备的影响。纳入了接种灭活(科兴)和基于 mRNA(辉瑞-生物科技)COVID-19 疫苗的医护人员( = 258)。所有受试者均完成了妇科和月经史问卷,并在首次接种前及接种后 1、3、6 和 9 个月采集血清样本测量抗苗勒管激素(AMH)水平。与基线相比( = 0.001),接种后新发月经失调的患病率为 20.6%,具有统计学意义。59.6%的接种女性月经模式恢复正常。与基线相比,血清 AMH 水平在随访 6 个月时逐渐下降( < 0.001)。与 6 个月随访水平相比,在随访 9 个月时观察到血清 AMH 水平显著升高( < 0.001)。无论血清抗 SARS-CoV-2 抗体水平、年龄亚组、接种后月经失调和妇科疾病的存在如何,血清 AMH 水平的下降均具有统计学意义。总之,接种 SARS-CoV-2 疫苗会导致血清 AMH 水平短暂下降和月经模式不规则,且随年龄增长而增加,且大多是可逆的。

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