SARS-CoV-2 感染和疫苗对卵巢储备功能的影响：系统评价。
Effect of SARS-CoV-2 infection and vaccine on ovarian reserve: A systematic review.
机构信息
Center for Reproductive Medicine, Shandong University, Jinan, Shandong, 250012, China; State Key Laboratory of Reproductive Medicine and Offspring Health, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; Shandong Technology Innovation Center for Reproductive Health, Jinan, Shandong, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China.
College of Clinical Medicine, Jining Medical University, Jining, China.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2024 Jan;292:63-70. doi: 10.1016/j.ejogrb.2023.10.029. Epub 2023 Oct 27.
OBJECTIVE
To evaluate the effect of SARS-CoV-2 infection and vaccination on ovarian reserve.
METHODS
Relevant articles were identified in the EMBASE, PubMed, and Web of Science databases from January 2020 to May 2023. Available clinical indicators of ovarian reserve, such as anti-Müllerian hormone (AMH), antral follicle count (AFC), follicle-stimulating hormone (FSH), and estradiol (E2), as well as the time interval from infection or vaccination to measurements, were assessed.
RESULTS
Only 2 studies provided evidence that SARS-CoV-2 infection could damage ovarian function. In a comparison of the vaccinated and unvaccinated groups, although 1 prospective cohort study observed the transient statistically significant decrease on serum AMH levels at 3 or 6 months of follow-up, serum AMH levels remained within the normal reserve range (>1.1 ng/dl) throughout the study period.
CONCLUSION
Overall, whether ovarian reserve may be affected by SARS-CoV-2 infection remains controversial and further investigations are warranted to clarify this issue. Based on the current evidence, it is safe to assume that COVID-19 vaccination does not exert any adverse effect on ovarian reserve parameters such as AMH, AFC, FSH, and E2, which will provide reassurance for women attempting to fall pregnant.
目的
评估 SARS-CoV-2 感染和接种疫苗对卵巢储备的影响。
方法
在 2020 年 1 月至 2023 年 5 月期间，在 EMBASE、PubMed 和 Web of Science 数据库中检索相关文献。评估了卵巢储备的可用临床指标，如抗苗勒管激素（AMH）、窦卵泡计数（AFC）、卵泡刺激素（FSH）和雌二醇（E2），以及从感染或接种疫苗到测量的时间间隔。
结果
只有 2 项研究提供了 SARS-CoV-2 感染可能损害卵巢功能的证据。在接种组和未接种组的比较中，虽然 1 项前瞻性队列研究观察到接种后 3 或 6 个月血清 AMH 水平有短暂的统计学显著下降，但整个研究期间血清 AMH 水平仍处于正常储备范围内（>1.1ng/dl）。
结论
总体而言，SARS-CoV-2 感染是否会影响卵巢储备仍存在争议，需要进一步研究来阐明这一问题。根据目前的证据，可以安全地假设 COVID-19 疫苗接种对 AMH、AFC、FSH 和 E2 等卵巢储备参数没有任何不良影响，这将为试图怀孕的女性提供安心。
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