Brief Report: The Euro‐Lupus Low‐Dose Intravenous Cyclophosphamide Regimen Does Not Impact the Ovarian Reserve, as Measured by Serum Levels of Anti–Müllerian Hormone
Cohort study demonstrates preserved anti-Müllerian hormone levels after low-dose cyclophosphamide in lupus patients, indicating safe fertility preservation.
Key Points
To evaluate whether the low-dose Euro-Lupus intravenous cyclophosphamide regimen damages the ovarian reserve in premenopausal women with systemic lupus erythematosus.
Measured serum anti-Müllerian hormone (AMH) concentrations via ELISA in a cohort of 155 premenopausal patients with systemic lupus erythematosus (SLE).
Compared 30 patients treated with the Euro-Lupus regimen (cumulative dose 3 g) against 24 patients receiving higher doses (>6 g) and control patients never treated with intravenous cyclophosphamide.
Adjusted AMH levels for age using a slope derived from the untreated cohort, and analyzed paired pre- and post-treatment samples in a patient subset.
Median serum AMH titers did not differ significantly between patients receiving the Euro-Lupus regimen (1.46 ng/ml) and those never exposed to cyclophosphamide (1.85 ng/ml).
Patients receiving high-dose intravenous cyclophosphamide (>6 g) showed significantly lower median AMH levels (0.83 ng/ml) compared to unexposed controls (1.85 ng/ml; P = 0.047).
Paired testing showed no significant change in median serum AMH titers before (1.24 ng/ml) versus after (2.50 ng/ml) Euro-Lupus therapy (P = 0.43).