Abstract Objective: To investigate whether systemic lupus erythematosus (SLE) has a negative impact on the fertility of young women of reproductive age through SLE activity and therapy. Methods: This retrospective case–control study was conducted in 50 patients with SLE and 50 healthy controls who fulfilled the 1997 American College of Rheumatology criteria. Anti-Müllerian hormone (AMH) levels were measured, and ovarian volume (OV) and total antral follicle count (AFC) were assessed by transvaginal sonar in pa- tients and in healthy controls. Analysis was carried out on the association of SLE dis- ease activity with AMH, OV, and AFC. Results: SLE patients had decreased levels of AMH, OV, and AFC, correlating with age, activity, and damage levels of SLE, displaying a negative consequence of SLE. In the SLE group, the CD4+ T cells and natural killer cells were significantly reduced (P < 0.05). Conclusion: AMH levels and AFC were decreased in women with SLE with autoim- mune activity and CD8+ T-cell activation; they can be used as useful markers and account for a high proportion of women with low ovarian reserve.