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

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 NCT04822012 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.