The new advances in the treatment have greatly increased the life expectancy of premenopausal women with hematological malignancies. The susceptibility of their ovarian reserve to chemotherapy is however highly variable. The anti-mullerian hormone (AMH) is one of the most sensitive markers of ovarian reserve and fertility preservation. In this study, antral follicle counts (AFC), serum AMH, follicle stimulating hormone (FSH) and inhibin B were assayed in female patients treated for lymphoma and hematological disease to characterize the evolution of fertility preservation. 63 consecutive women (48 with Hodgkin's lymphoma, 9 non-Hodgkin's lymphoma, 6 acute myeloid leukemia) were eligible for enrolment. All patients [median age, 31 years (range: 17-40)] were in complete remission with a median follow-up time of 9.0 years after therapy. 64 healthy controls were also evaluated [median age, 31 years (range: 20-42)]. Participants had a baseline blood drawing during the early follicular phase of the menstrual cycle. A significant difference in AFC (9.8 vs. 16.0, P=0.0001), AMH (2.02 μg/L vs. 2.97 μg/L, P=0.02), FSH (16.9 U/L vs. 8.1 U/L, P=0.03) and inhibin B (33.7 ng/L vs. 69.4 ng/L, P <0.005) was observed between patients and controls. The ROC curve analysis comparing AMH and FSH concentrations of patients (at the same AFC cut-off point of 8) revealed that AMH had a better area under the curve (0.904) than FSH (0.678) (P=0.0013). The ovarian reserve is reduced in female patients affected by hematological malignancies after chemotheraphy. AMH is the most reliable serum marker of fertility preservation in these subjects. © 2014 biochimica clinica.
Utility of anti-mullerian hormone for the evaluation of fertility preservation in female patients after chemotherapy [Determinazione dell'ormone anti-mulleriano per la valutazione della riserva ovarica in pazienti dopo trattamento chemioterapico]
Salvagno G. L.;DI PAOLA, Rossana;Zaffagnini S.;Gelati M.;Perandini A.;Tecchio C.;Montemezzi R.;Franchi M.;Guidi G. C.
2014-01-01
Abstract
The new advances in the treatment have greatly increased the life expectancy of premenopausal women with hematological malignancies. The susceptibility of their ovarian reserve to chemotherapy is however highly variable. The anti-mullerian hormone (AMH) is one of the most sensitive markers of ovarian reserve and fertility preservation. In this study, antral follicle counts (AFC), serum AMH, follicle stimulating hormone (FSH) and inhibin B were assayed in female patients treated for lymphoma and hematological disease to characterize the evolution of fertility preservation. 63 consecutive women (48 with Hodgkin's lymphoma, 9 non-Hodgkin's lymphoma, 6 acute myeloid leukemia) were eligible for enrolment. All patients [median age, 31 years (range: 17-40)] were in complete remission with a median follow-up time of 9.0 years after therapy. 64 healthy controls were also evaluated [median age, 31 years (range: 20-42)]. Participants had a baseline blood drawing during the early follicular phase of the menstrual cycle. A significant difference in AFC (9.8 vs. 16.0, P=0.0001), AMH (2.02 μg/L vs. 2.97 μg/L, P=0.02), FSH (16.9 U/L vs. 8.1 U/L, P=0.03) and inhibin B (33.7 ng/L vs. 69.4 ng/L, P <0.005) was observed between patients and controls. The ROC curve analysis comparing AMH and FSH concentrations of patients (at the same AFC cut-off point of 8) revealed that AMH had a better area under the curve (0.904) than FSH (0.678) (P=0.0013). The ovarian reserve is reduced in female patients affected by hematological malignancies after chemotheraphy. AMH is the most reliable serum marker of fertility preservation in these subjects. © 2014 biochimica clinica.
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