Ovarian follicular function is not altered by SARS-Cov-2 infection or BNT162b2 mRNA Covid-19 vaccination

  1. Yaakov Bentov
  2. Ofer Beharier
  3. Arbel Moav-Zafrir
  4. Maor Kabessa
  5. Miri Godin
  6. Caryn S. Greenfield
  7. Mali Ketzinel-Gilad
  8. Efrat Esh Broder
  9. Hananel E. G. Holzer
  10. Dana Wolf
  11. Esther Oiknine-Djian
  12. Iyad Barghouti
  13. Debra Goldman-Wohl
  14. Simcha Yagel
  15. Asnat Walfisch
  16. Anat Hersko Klement
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Abstract

Importance

This is the first study to examine the impact of SARS-Cov-2 infection and COVID-19 vaccination on ovarian function.

Objective

To characterize anti-COVID-19 antibodies in follicular fluid and compare ovarian follicle function in women following confirmed SARS-CoV-2 infection, COVID-19 vaccination, and non-infected, unvaccinated controls.

Design

This is a cohort study conducted between February 1 and March 10, 2021.

Setting

A single university hospital-based IVF clinic.

Participants

Consecutive sample of female patients undergoing oocyte retrieval.

Interventions

Consenting patients were recruited and assigned to one of three study groups: recovering from confirmed COVID 19 (n=9); vaccinated (n=9); and uninfected, non-vaccinated controls (n=14). Serum and follicular fluid samples were taken and analyzed for anti-COVID IgG as well as estrogen, progesterone and HSPG2 concentration, as well as the number and maturity of aspirated oocytes and previous estrogen and progesterone measurements.

Main outcome measures

Follicular function, including steroidogenesis, follicular response to the LH/hCG trigger, and oocyte quality biomarkers.

Results

Both natural and vaccine elicited anti-COVID IgG antibodies were detected in the follicular fluid in levels proportional to the IgG serum concentration. No differences were detected in any of the surrogate ovarian follicle quality reporting parameters.

Conclusions and relevance

Both SARS-COV-2 infection and vaccination with the BNT162b2 mRNA vaccine mediate IgG immunity that crosses into the follicular fluid. No detrimental effect on follicular function was detected.

Trial Registration

CinicalTrials.gov registry number <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT04822012">NCT04822012</ext-link>

Key Point

COVID 19 disease and BNT162b2 mRNA vaccine induce anti-COVID IgG in follicular fluid; neither recent infection nor vaccination appear to negatively effect follicular function.

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