Review
The impact of Sjögren's disease on ovarian reserve: a systematic review and meta-analysis
J. Wang1, Y. Han2, M. Chu3, W. Huang4, J. Yang5, Y. Xu6, Z. Wang7, W. Wu8, Y. Yan9
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin; and National Clinical Research Center for Chinese Medicine, Tianjin, China.
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin; and National Clinical Research Center for Chinese Medicine, Tianjin, China.
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin; and National Clinical Research Center for Chinese Medicine, Tianjin, China.
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China.
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin; and National Clinical Research Center for Chinese Medicine, Tianjin, China.
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin; and National Clinical Research Center for Chinese Medicine, Tianjin, China.
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
- Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China.
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin; and National Clinical Research Center for Chinese Medicine, Tianjin, China. yanying799@163.com
CER19767
Review
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Received: 05/02/2026
Accepted : 26/03/2026
In Press: 01/06/2026
Abstract
OBJECTIVES:
Because immune-mediated mechanisms in Sjögren’s disease (SjD) may impair ovarian reserve, this study evaluated the association between SjD and ovarian reserve to inform fertility counselling and clinical management.
METHODS:
Following PRISMA 2020 guidelines (PROSPERO: CRD420251182803), we searched five databases (PubMed, Embase, Web of Science, Cochrane Library, and CBM) through December 1, 2025. Eligible observational studies quantitatively compared serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), antral follicle count (AFC), or ovarian volume (OV) between reproductive-age women with SjD and age-matched disease-free controls. Study quality was assessed using the Newcastle-Ottawa Scale and AHRQ tool, and continuous outcomes were synthesised using standardised mean differences (SMDs) with 95% confidence intervals (CIs).
RESULTS:
Across four observational studies involving 410 participants, women with SjD exhibited significantly lower AMH levels compared with controls (SMD=-0.73, 95% CI -1.09 to -0.37; p<0.0001). Additionally, a trend toward higher FSH levels was observed (SMD=0.35, 95% CI 0.14 to 0.57; p<0.001), although statistical significance remained sensitive to the inclusion of specific studies. Conversely, no significant differences were observed for AFC (SMD=-0.58, 95% CI -1.70 to 0.55; p=0.31) or OV (SMD=-0.18, 95% CI -0.57 to 0.21; p=0.36).
CONCLUSIONS:
Although limited data prevent definitive confirmation of how SjD affects ovarian reserve, this preliminary study strongly underscores the critical need for increased clinical awareness of the condition in reproductive medicine.
