PECULIARITIES OF THE FUNCTIONAL STATE OF THE OVARIES IN WOMEN WITH INFERTILITY OF REPRODUCTIVE AGE AFTER THE DISEASE OF COVID-19

Abstract

The coronavirus disease (COVID-19) recognized as a pandemic caused by the rapid spread of the SARS-CoV-2 coronavirus has become a serious challenge for the health care system around the world. As you know, this virus can affect the body as a whole and affects, along with the respiratory system, the cardiovascular, locomotor, nervous and reproductive systems. Various processes in the female reproductive system, including folliculogenesis, steroidogenesis, and oocyte maturation, are regulated by the renin-angiotensin-aldosterone system, which includes angiotensin-converting enzyme 2 (ACE2). Taken together, these studies suggest that the female reproductive system, expressing ACE2, has a high potential for susceptibility to SARS-CoV-2 entry. The aim of the study was to assess the impact of SARS-CoV-2 infection on the functional state of the ovaries in women of reproductive age with infertility.

Materials and methods. 100 female patients aged 18–40 who applied to the Carpathian Center for Human Reproduction in Ivano-Frankivsk in the period 2020-2022 were examined. about the treatment of infertility. The main group is 80 women after having experienced COVID-19, the comparison group is 20 women without a history of COVID-19. To assess the functional state of the ovaries, the levels of follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), luteinizing hormone (LH), estradiol (E₂) and progesterone were determined. To determine the content of LH, FSH, E₂ and progesterone in blood serum, an immunoenzymatic method (ELISA) was used on a Cobas 6000 analyzer with test systems from Roche Diagnostics (Switzerland), blood for hormone determination was collected on the 3rd day of the menstrual cycle. The level of AMH was determined using the Beckman Coulter (USA) test system. The characteristics of menstrual status and accompanying gynecological pathologies were evaluated. The obtained data were processed by methods of variational statistics using Fisher's angular transformation with a critical significance level of p<0.05.

Results. A partial effect of the disease of COVID-19 on the reproductive function, namely, on the ovarian reserve, as evidenced by the reduced levels of AMH, was revealed. Also, a significantly higher frequency of menstrual disorders after suffering from COVID-19 was noted, namely, an increase in the duration of menstruation and the level of blood loss, irregular cycles. These changes in menstrual status may also be related to changes in the immune response of the body as a whole due to the disease of COVID-19.

Conclusions. According to the results of the study, it was proven that the SARS-CoV-2 virus is able to influence the functional state of the ovaries, as evidenced by changes in the levels of anti-Müllerian hormone. Women of reproductive age experience changes in menstrual status, namely, irregular cycles and hyperpolymenorrhea, for at least 3 months after contracting COVID-19. Women who have experienced COVID-19 have a high prevalence of genitourinary infections, which may be due to changes in the work of the immune system. Understanding the mechanisms of the impact of the SARS-CoV-2 virus on the reproductive system will contribute to the development of ways to prevent infertility and reproductive losses in women who have experienced COVID-19.