Figure 1: Contributory factors causing menstrual irregularity, ovarian failure and infertility in women with systemic lupus erythematosus. SLE involves many organ systems. The ovarian function can be compromised both autoimmune oophorotis; and by gonadotoxic effects of cyclophosphamide. In addition, hormonal imbalances and altered hypothalamic pituitary ovarian axis can further contribute to ovarian dysfunction culminating in menstrual irregularity, infertility and ovarian failure.