Evaluation of anti-Mullerian hormone as parameter of ovarian function in patients with systemic lupus erythematosus: A systematic review and meta-analysis

Abstract

HIGHLIGHTS Systemic Lupus Erythematosus (SLE) patients show a strong correlation between Anti-Mullerian Hormone (AMH) levels and ovarian function. Lower AMH levels indicate higher risk of impaired ovarian function and diminished reserve, as revealed by this meta-analysis. The comprehensive synthesis of available data in this study has important clinical implications for the management and counseling of Systemic Lupus Erythematosus (SLE) patients. ABSTRACT Objective: The assessment of ovarian function in patients with systemic lupus erythematosus (SLE) holds paramount importance for both clinicians and patients. This systematic review and meta-analysis delves into the role of anti-Mullerian hormone (AMH) as a key marker in evaluating ovarian function among SLE patients. Our study aims to provide valuable insights for clinicians managing ovarian function assessments and to offer practical recommendations for differences in therapy for patient care. Materials and Methods: Studies comparing serum AMH levels between patients with systemic lupus erythematosus and healthy controls, as well as serum AMH levels between SLE patients, are necessary. PRISMA guidelines were used for this systematic review. Databases like PubMed, SCOPUS, EuropePMC, ProQuest, and Cochrane Central were searched using specific terms ("Anti-Mullerian Hormone" or "Ovarian Function" and "Systemic Lupus Erythematosus") for publications between 2000 and 2023. After removing duplicates, authors screened remaining articles based on abstracts, then reviewed selected abstracts in full-text. Studies meeting criteria were included based on unanimous agreement among investigators, with any disagreements resolved through author consensus. Results: Data There were 12 eligible studies. In this research, we identified a link between SLE and diminished levels of AMH. Furthermore, it was observed that SLE patients undergoing cyclophosphamide (CYC) treatment also exhibited lowered AMH levels Conclusion: The systematic review underscores the heightened risk of reduced ovarian reserve in SLE patients. Importantly, CYC treatment emerged as a factor contributing to compromised ovarian reserve. For individuals with systemic lupus erythematosus, particularly women in their reproductive years, assessing serum AMH levels can serve as a pivotal tool to inform therapeutic decisions and preserve ovarian health. Our study contributes to enhanced clinical understanding and patient care within the realm of SLE and reproductive health.