Introduction Immunosuppression with Cyclophosphamide is treatment of choice in lupus nephritis. Ovarian reserve depletion is well known complication. Early identification of depletion of ovarian reserve can be done by correlating antral follicle count with AMH.

Aims- To assess the ovarian reserve in patients who have receive d IV Cyclophosphamide vs those who have received Mycophenolate-mofetil for SLE by measuring AMH, Inhibin B, FSH and antral follicular count.

Methods A prospective Case-Control study with 50 patients who were diagnosed with SLE were studied. Twenty-five cases and controls defined by females age 18-40 with SLE were enrolled. Cases received IV CYC as per NIH protocol and controls received oral MMF. Baseline FSH, LH, E2, AMH, Inhibin and antral follicular count, and at 6 months were done in both the groups.

Results Mean age: cases- 31.36±6.357, controls- 28.36±4.396 (p-0.058).

Conclusions MMF did not cause decrease in ovarian reserve. IV CYC caused Subclinical depletion of ovarian reserve with significant decreased in AMH, Inhibin B and E2 levels and follicular counts. AMH and AFC are good markers to assess subclinical depletion of ovarian reserve