Isotretinoin is among the most frequently used medications in the dermatologic daily practice.
With a Black box warning, teratogenicity is amajor concern. Female fertilitymay be an
issue to be investigated when it comes to its use in females. The aim of this work was to
assess the effect of low dose isotretinoin on the ovarian reserve in female patients with
moderate to severe acne. Sixty-sex female acne patients candidate for isotretinoin therapy
and 66 controls were enrolled in this prospective controlled cohort study. Low dose isotretinoin
(0.25–0.4 mg/kg/day) was given to the patients group for 6 months. Serum anti-
Mullarian hormone (AMH), ovarian volume (OV) and Antral follicle count (AFC)were evaluated
at baseline and 6months after the last dose in the patients' group, and 1 year after the
baseline assessment for the control subjects. There was no significant difference in serum
AMH between patients after isotretinoin treatment and control subjects (p= 0.898). AMH
failed to show any significant change in pre- and post- treatment levels in patients' group
(p = 0.747). Both OV and AFC showed no significant changes in patient group when comparing
pre- post- treatment levels on both sides (p > 0.05) and in control group between
baseline and 1-year-interval levels on both sides (p > 0.05). Low-dose isotretinoin in treatment
of moderate to severe acne seems to be safer on ovarian reserve as indicated by
non-significant change in AMHlevels as a sensitive parameter of female fertility.