To explore the utility of Neurofilament light chain (NfL) and Antimüllerian hormone (AMH) in family planning in multiple sclerosis (MS). 

Serum NfL values are considered biomarkers for neuroaxonal injury. Their levels associate with relapse activity, disability scores, and treatment response in MS. On the other hand, AMH levels are a reliable marker of ovarian reserve and age at menopause. Interestingly, serum AMH levels do not change significantly throughout the menstrual cycle

A cross-sectional study was performed. We included naïve patients with MS, recruited at the time of diagnosis. Clinical and epidemiological data were analyzed. Serum NfL levels were measured with a sensitive single-molecule array (SIMOA) assay, and AMH levels were measured by ELISA. Descriptive and multivariate analyses were performed. Results are expressed by median and interquartile range 25%-75%.

We included 112 MS patients. Median age 35.25 years old (30.35-40.65). We divided the patients into two groups according to their AMH levels, using values that represented a median ovarian reserve. We found that age was significantly associated with AMH levels (P < 0.01. Median AMH values 0.2 ng/ml [0.1-0.5]).  We further divided our participants into two groups according to their NfL levels using a cut-off value of 10 pg/ml and found no statistical difference between groups (p: 0.3; median NfL: 7.5 pg/mL [5.5- 12.2]). Interestingly, when analyzing individual patients, we were able to identify those with an unexpectedly low AMH level, regardless of their age.

AMH levels can also be used as a biomarker of ovarian reserve in MS patients. Furthermore, our data suggest that AMH and NfL levels at diagnosis might help develop a personalized treatment strategy in patients of childbearing age and support informed decisions about whether or not to delay childbearing.