Beyond the Autoimmune Spectrum, Evaluating Ovarian Health in Systemic Lupus Erythematosus Patients: A Case-Control Study.

Background and Aims: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, and recent findings reveal that fertility and ovarian reserve are reduced even in moderate illness, showing that SLE has a direct impact on ovarian function. Therefore, this study aimed to evaluate ovarian reserve using Anti-Müllerian hormone (AMH) and antral follicle count (AFC) in SLE patients compared to healthy controls. Methods: This case-control study was performed on 300 cases (150 SLE patients and 150 healthy controls). For evaluating ovarian reserve, AMH and AFC were evaluated. Furthermore, SLE activity was determined through the employment of the SLEDAI-2k questionnaire. Results: Findings revealed that the mean serum levels of AMH were significantly lower in the SLE group as compared to healthy controls (1.34 ± 1.16 vs. 2.47 ± 1.48 ng/mL, p < 0.001). Moreover, left AFC (2.47 ± 1.57 vs. 5.3 ± 1.94, p < 0.001), right AFC (2.77 ± 1.83 vs. 5.04 ± 2.36, p < 0.001), and mean AFC (2.62 ± 1.56 vs. 5.17 ± 1.96, p < 0.001) were significantly lower in the SLE group compared to healthy controls. Moreover, the results of examining the relationship between controlled (SLEDAI-2K ≤ 4) and uncontrolled (SLEDAI-2K > 4) patients were significant in terms of AMH serum levels, which were significantly lower in uncontrolled patients (p < 0.001). Conclusions: According to the results of the present study, young women with SLE should check their ovarian reserve regularly, and both AMH and AFC should be evaluated periodically because ovarian reserve may be reduced faster in SLE cases.