Background Women with SLE have a higher risk of developing menstrual irregularities compared to a healthy population. Anti-Müllerian hormone (AMH) has been shown to have great promise as a possible marker of ovarian function. Some studies have suggested that AMH may be an early indicator of waning ovarian function in chemotherapy patients, and may be superior to current markers of ovarian reserve. Antral follicle count (AFC) also has a good correlation with ovarian response during assisted reproduction. Disease activity is a major factor in menstrual disorders in systemic lupus erythematosus (SLE) patients not receiving alkylating therapy. However, the ovarian reserve of SLE women with normal menstruation is still unclear.
Objectives To determine whether SLE patients with normal menstruation have effect on ovarian function.
Methods Twenty-three SLE patients without cytotoxic agents (SLE group) and nineteen SLE patients receiving current or previous cyclophosphamide (CTX) therapy (without other cytotoxic agents; SLE-CTX group) were enrolled. Twenty-one age-matched healthy women served as controls. All patients and controls had a regular menstrual cycle. Basal hormone levels, including FSH, LH, E2, and AMH, and antral follicle count (AFC) were analyzed in the two study groups and compared to the control group.
Results The basal average levels of serum FSH (P = 0.207) and LH (P = 0.518) were comparable between the three groups, but a trend of higher FSH levels was observed in the SLE-CTX group. Significantly higher basal estradiol values (53.27 ± 30.01 and 44.20 ± 14.22 vs. 36.10 ± 10.48 pg/ml; P = 0.007), lower AMH levels (1.15 ± 1.28 and 1.71 ± 1.29 vs. 3.33 ± 1.76 ng/ml; P = 0.000) and less AFC (7.80 ± 4.54 and 10.90 ± 3.00 vs. 14.61 ± 4.93; P = 0.001) were observed in the SLE-CTX and SLE groups compared to the control group, respectively, but were similar between the SLE-CTX and SLE groups.
Conclusions AMH may serve as a marker of early ovarian insufficiency in SLE patients. SLE patients not receiving CTX therapy who had normal menstruation and short illness duration still had an impaired ovarian reserve.
Disclosure of Interest: None Declared