NYMC Faculty Publications
Premature Ovarian Insufficiency After Coronavirus Disease 2019 (Covid-19): Autoimmune Follicle-Stimulating Hormone (Fsh) and Fsh Receptor Blockade
Author Type(s)
Faculty
DOI
10.1097/AOG.0000000000005574
Journal Title
Obstetrics and Gynecology
First Page
e149
Last Page
e152
Document Type
Article
Publication Date
6-1-2024
Department
Obstetrics and Gynecology
Abstract
BACKGROUND: Since the onset of the coronavirus disease (COVID-19) pandemic, a variety of long-COVID-19 symptoms and autoimmune complications have been recognized. CASES: We report three cases of autoimmune premature poor ovarian response in patients aged 30-37 years after mild to asymptomatic COVID-19 before vaccination, with nucleotide antibody confirmation. Two patients failed to respond to maximum-dose gonadotropins for more than 4 weeks, despite a recent history of response before having COVID-19. After a month of prednisone 30 mg, these two patients had normal follicle-stimulating hormone (FSH) levels, high oocyte yield, and blastocyst formation in successful in vitro fertilization cycles. All three patients have above-average anti-müllerian hormone levels that persisted throughout their clinical ovarian insufficiency. Two patients had elevated FSH levels, perhaps resulting from FSH receptor blockade. One patient, with a history of high response to gonadotropins 75 international units per day and below-normal FSH levels, had no ovarian response to more than a month of gonadotropins (525 international units daily), suggesting autoimmune block of the FSH glycoprotein and possible FSH receptor blockade. CONCLUSION: Auto-antibody production in response to COVID-19 before vaccination may be a rare cause of autoimmune poor ovarian response. Although vaccination is likely protective, further study will be required to evaluate the effect of vaccination and duration of autoimmune FSH or FSH receptor blockade.
Recommended Citation
Stern, R., Bibi, M., & Keltz, M. D. (2024). Premature Ovarian Insufficiency After Coronavirus Disease 2019 (Covid-19): Autoimmune Follicle-Stimulating Hormone (Fsh) and Fsh Receptor Blockade. Obstetrics and Gynecology, 143 (6), e149-e152. https://doi.org/10.1097/AOG.0000000000005574