Document Detail


Assessment of ovarian reserve in adult childhood cancer survivors using anti-Müllerian hormone.
MedLine Citation:
PMID:  19153092     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim was to assess possible treatment-induced gonadal damage in a cohort of adult female childhood cancer survivors (CCS) using anti-Müllerian hormone (AMH), the most sensitive marker of ovarian reserve. METHODS: A total cohort of 185 survivors was compared with 42 control subjects. The median follow-up time was 18.1 years (range 4.1-43.2 year). RESULTS: Median AMH concentrations in the analysed cohort were not different from controls (median 1.7 versus 2.1 microg/l; P = 0.57). However, AMH levels were lower than the 10th percentile of normal values in 27% (49/182) of our survivors. In addition, 43% (79/182) had AMH levels lower than 1.4 microg/l, a previously established cut-off value which predicts ongoing pregnancy after assisted reproduction. There were no differences in AMH levels in subgroups classified according to disease. However, survivors treated with three or more procarbazine containing chemotherapy cycles had significantly lower AMH levels than controls (median 0.5 microg/l; P = 0.004). Also survivors treated with abdominal or total body irradiation had significantly lower AMH levels than controls (median < 0.1 microg/l; P < 0.001). CONCLUSIONS: AMH can be used to identify subgroups of CCS at risk for decreased fertility or premature ovarian failure. In these survivors, options for fertility preservation should be considered prior to starting treatment since they may be at risk for poor chances of pregnancy after assisted reproductive treatment.
Authors:
S Lie Fong; J S E Laven; F G A J Hakvoort-Cammel; I Schipper; J A Visser; A P N Themmen; F H de Jong; M M van den Heuvel-Eibrink
Publication Detail:
Type:  Journal Article     Date:  2009-01-18
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  24     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-18     Completed Date:  2009-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  982-90     Citation Subset:  IM    
Affiliation:
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands. s.liefong@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Mullerian Hormone / blood*
Antineoplastic Combined Chemotherapy Protocols / adverse effects
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Female
Humans
Infant
Infertility, Female / blood,  etiology,  therapy
Middle Aged
Neoplasms / complications*,  therapy*
Ovarian Failure, Premature / blood,  etiology
Ovary / injuries*,  physiopathology*
Pregnancy
Radiation Injuries / complications
Reproductive Techniques, Assisted
Young Adult
Chemical
Reg. No./Substance:
80497-65-0/Anti-Mullerian Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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