COVID-19 Reduces Anti-Müllerian Hormone in Women of Reproductive Age, Effects on Male Fetuses Still Unknown
Nikhil Prasad Fact checked by:Thailand Medical News Team May 07, 2025 1 day, 3 hours, 12 minutes ago
Medical News: In a concerning development for reproductive health, a team of Turkish researchers has found that women of reproductive age who contracted COVID-19 experienced a decline in levels of a vital reproductive hormone called anti-Müllerian hormone (AMH), which is a key marker for fertility. While the study stops short of confirming long-term fertility damage, the findings signal a need for further urgent investigation, especially regarding potential impacts on future pregnancies and male fetal development.
COVID-19 Reduces Anti-Müllerian Hormone in Women of Reproductive Age, Effects on Male Fetuses Still Unknown
The groundbreaking study was conducted by researchers from the University of Health Sciences Turkey at Bakırköy Dr. Sadi Konuk Training and Research Hospital in Istanbul, along with collaborators from Tekirdağ Namık Kemal University Faculty of Medicine, Sason City Hospital, and the University of Health Sciences Hamidiye Faculty of Medicine. This
Medical News report delves into the study’s findings, methodology, and the broader implications for women’s reproductive health in a post-COVID world.
What Is Anti-Müllerian Hormone and Why It Matters
Anti-Müllerian hormone (AMH) plays a central role in reproductive biology. In males, AMH is produced by the testes during fetal development and is crucial in preventing the formation of female reproductive structures like the uterus and fallopian tubes. In females, AMH is secreted by granulosa cells in the ovaries and is used as a clinical marker to estimate ovarian reserve—the number of viable eggs a woman has.
Higher levels of AMH typically indicate better fertility prospects, while lower levels suggest diminished ovarian reserve. AMH levels are now routinely measured in fertility assessments and are used to diagnose reproductive disorders like polycystic ovary syndrome (PCOS) or to monitor responses to fertility treatments.
How the Study Was Conducted
The prospective study included 34 non-pregnant women aged 24 to 38 who had tested positive for COVID-19. All participants had regular menstrual cycles and no preexisting reproductive issues. The researchers measured their blood AMH levels at the time of diagnosis and again six months after recovery.
Alongside AMH, other inflammatory markers such as white blood cell count, C-reactive protein (CRP), ferritin, and procalcitonin were also recorded to gauge the body’s immune response during and after infection.
Key Findings of the Study
Six months post-infection, AMH levels had declined in most of the women. On average, there was a drop of 0.31 ng/dL from baseline. While this number might seem small, the decline was statistically significant and more pronounced in women who had higher levels of inflammatory markers during their infection.
-Correlation with Immune Response: AMH decline was strongly associated w
ith elevated inflammatory markers like CRP, ferritin, and procalcitonin.
-White Blood Cell Impact: A moderate negative correlation was observed between changes in AMH and the number of white blood cells, further implicating the immune response in the ovarian changes.
-No Change in Other Parameters: There was no significant change in levels of hormones like estrogen or FSH, which are also tied to reproductive function, indicating the specificity of AMH’s sensitivity to COVID-19-related inflammation.
Why These Findings Are Concerning
The decline in AMH levels raises several concerns:
-Potential Long-Term Fertility Issues: Since AMH reflects ovarian reserve, a significant drop—even if temporary—could influence a woman’s fertility window and her ability to conceive naturally.
-Systemic Inflammation May Be the Culprit: The link between inflammatory markers and AMH drop suggests that systemic inflammation, a hallmark of COVID-19, may be damaging ovarian follicles.
-Unknown Effects on Male Fetuses: Since AMH is also crucial in male fetal development—preventing the formation of female reproductive structures—it is unclear whether a COVID-infected mother could experience alterations in fetal AMH signaling. Further research is needed to explore these fetal risks.
Limitations of the Study
The authors acknowledge that their study had some limitations:
-Sample Size: With only 34 participants, the statistical power was relatively low (0.62), meaning larger studies are needed to confirm the findings.
-Short Follow-Up: The study only followed participants for six months. Longer-term data is essential to assess whether AMH levels rebound or continue to decline.
-Severity Variability: Women with severe COVID-19 who required intensive care were excluded, meaning the effects of more serious illness remain unexplored.
Despite these limitations, the researchers believe their findings provide an important foundation for future research into how COVID-19 impacts female fertility, especially considering the possibility of long COVID and persistent systemic inflammation.
Future Directions and Recommendations
Based on the study and supporting evidence, experts are calling for:
-Longitudinal Studies: Monitoring women for several years post-infection to assess long-term fertility trends.
-Larger Cohorts: Expanding the participant pool to include more diverse demographics and varying disease severities.
-Male Fetal Research: Exploring whether maternal COVID-19 infection affects fetal AMH production and sexual development in male offspring.
Clinicians are also encouraged to be vigilant in tracking menstrual and hormonal changes in women recovering from COVID-19 and to consider AMH testing in women facing fertility challenges post-infection.
Conclusion
COVID-19’s potential impact on female fertility continues to unfold, and this new study highlights one of the more subtle yet potentially significant consequences. The observed decline in anti-Müllerian hormone levels six months after infection suggests that even mild or moderate cases of COVID-19 could alter a woman’s ovarian reserve through inflammatory mechanisms. While not conclusive, the correlation between inflammation and decreased AMH levels is a cause for concern and warrants deeper examination. Equally important is the unexplored territory of how maternal infection might affect male fetal development, given the crucial role of AMH in preventing female organ formation in male fetuses.
Overall, these findings serve as a call to action for the medical and scientific communities to prioritize reproductive health monitoring in the context of COVID-19 and long COVID.
The study findings were published in the peer reviewed Journal of the Turkish-German Gynecological Association.
https://www.jtgga.org/articles/does-covid-19-reduce-anti-mullerian-hormone-levels-in-women-of-reproductive-age-in-late-periods-of-infection/doi/jtgga.galenos.2023.2023-2-3
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https://www.thailandmedical.news/news/covid-19-causes-endocrine-issues-such-as-suppressed-function-of-the-thyroid-gland,-suppressed-male-sex-hormone-secretion-and-elevated-prolactin
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