Document Detail


Impact of cancer therapies on ovarian reserve.
MedLine Citation:
PMID:  22137491     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether measures of ovarian reserve differ between females exposed to cancer therapies in a dose-dependent manner as compared with healthy controls of similar age and late reproductive age.
DESIGN: Cross-sectional analysis of data from a prospective cohort study.
SETTING: University medical center.
PATIENT(S): Seventy-one cancer survivors aged 15-39 years; 67 healthy, similarly aged unexposed subjects; and 69 regularly menstruating women of late reproductive age (40-52 years).
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Early follicular-phase hormones (FSH, E(2), inhibin B, antimüllerian hormone [AMH]) and ovarian ultrasound measurements (ovarian volume and antral follicle counts [AFC]) were compared using multivariable linear regression.
RESULT(S): In adjusted models, FSH, AMH, and AFC differed between exposed vs. unexposed subjects (FSH 11.12 mIU/mL vs. 7.25 mIU/mL; AMH 0.81 ng/mL vs. 2.85 ng/mL; AFC 14.55 vs. 27.20). In participants with an FSH <10 mIU/mL, survivors had lower levels of AMH and AFC compared with controls. Alkylating agent dose score was associated with increased levels of FSH and decreased levels of AMH. Exposure to pelvic radiation was associated with impairment in FSH, AMH, AFC, and ovarian volume. Antimüllerian hormone was similar in women previously exposed to high-dose cancer therapy and 40-42-year-old controls.
CONCLUSION(S): Measures of ovarian reserve are impaired in a dose-dependent manner among cancer survivors compared with unexposed females of similar age. Reproductive hormone levels in menstruating survivors exposed to high-dose therapy are similar to those in late-reproductive-age women. The predictive value of measures for pregnancy and menopause must be studied. CLINICALTRIALS.GOV IDENTIFIER: NCT01143844.
Authors:
Clarisa R Gracia; Mary D Sammel; Ellen Freeman; Maureen Prewitt; Claire Carlson; Anushree Ray; Ashley Vance; Jill P Ginsberg
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-02
Journal Detail:
Title:  Fertility and sterility     Volume:  97     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-23     Completed Date:  2012-02-16     Revised Date:  2013-07-10    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  134-40.e1     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Obstetrics/Gynecology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. cgracia@obgyn.upenn.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01143844
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Anti-Mullerian Hormone / blood
Antineoplastic Agents / adverse effects*
Cross-Sectional Studies
Dose-Response Relationship, Drug
Estradiol / blood
Female
Follicle Stimulating Hormone / blood
Humans
Infertility, Female / blood,  chemically induced*,  ultrasonography
Inhibins / blood
Menopause / drug effects
Middle Aged
Neoplasms / drug therapy*
Ovary / drug effects*
Predictive Value of Tests
Pregnancy
Pregnancy Complications, Neoplastic / blood,  chemically induced*,  ultrasonography
Prospective Studies
Young Adult
Grant Support
ID/Acronym/Agency:
1 UL1 RR024926-01/RR/NCRR NIH HHS; KL1 CA133839/CA/NCI NIH HHS; KL1-CA-133839-01/CA/NCI NIH HHS; R01 HD062797/HD/NICHD NIH HHS; R01HD062797-02/HD/NICHD NIH HHS; UL1 RR024926/RR/NCRR NIH HHS; UL1RR024134/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/inhibin B; 50-28-2/Estradiol; 57285-09-3/Inhibins; 80497-65-0/Anti-Mullerian Hormone; 9002-68-0/Follicle Stimulating Hormone

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