Structural and Hormonal Changes in Reproductive-Age Women Post-COVID-19: A Cross-Sectional Ultrasound and Biochemical Study

<b>Background/Objectives:</b> The long-term impact of COVID-19 on female reproductive health remains poorly understood. This study aimed to assess structural and endocrine alterations in women of reproductive age who had recovered from SARS-CoV-2 infection compared to uninfected controls. <b>Materials and Methods:</b> A total of 150 women aged 18-45 years were enrolled in a comparative study: 75 with a confirmed history of COVID-19 and 75 without one. All participants underwent ultrasound examinations of their pelvic organs and mammary glands, along with laboratory assessment of reproductive hormones and inflammatory markers. <b>Results:</b> Structural abnormalities in the pelvic organs were observed in 53.5% of the post-COVID-19 group versus 12.0% of the control group (<i>p</i> < 0.001), with oophoritis showing a statistically significant association (OR = 11.38; 95% CI: 1.42-91.36; <i>p</i> = 0.009). Non-significant but elevated frequencies were also found for uterine fibroids and breast cysts. Biochemically, post-COVID-19 participants demonstrated higher serum ferritin, estradiol, and fibrinogen levels, along with lower TSH and AMH levels, suggesting potential endocrine disruption and persistent inflammation. <b>Conclusions:</b> Women with a history of COVID-19 may be at increased risk of developing structural and hormonal abnormalities, highlighting the importance of post-infection gynecological and endocrine monitoring. Further longitudinal studies are required to elucidate the long-term effects and underlying mechanisms of these alterations.