Assessment of ovarian reserve in adult childhood cancer survivors using anti-Mullerian hormone

Fong, Sharon Lie; Laven, Joop S.E.; Hakvoort-Cammel, F. G. A. J.; Schipper, I.; Visser, Jenny A.; Themmen, Axel P. N.; Jong, Frank H. de; Heuvel‐Eibrink, Marry M. van den

doi:10.1093/humrep/den487

Cited by 163 publications

(48 citation statements)

References 36 publications

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“…In this respect, the value of serum AMH concentration is currently gaining attention for the assessment of fertility. Several studies have evaluated the use of serum AMH concentration to assess ovarian damage in females surviving childhood malignancy [19,20,21,22,23]. The most recent report by Brougham et al [23] showed AMH to be a marker of gonadotoxicity in a prospective study of 22 pre- and postpubertal females treated for cancer.…”

Section: Discussionmentioning

confidence: 99%

“…AMH levels are reduced after chemotherapy and radiotherapy; therefore, AMH is currently considered to be a useful indicator of the long-term impact of chemotherapy on reproduction capacity in adult females [17,18]. Recent reports have examined the use of AMH for the prediction of ovarian reserve in female CCSs [19,20,21,22]. The aim of the present retrospective study was to measure serum AMH concentrations and compare them with those of gonadotropin to evaluate ovarian function in CCSs.…”

Section: Introductionmentioning

confidence: 99%

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Low Serum Concentrations of Anti-Müllerian Hormone Are Common in 53 Female Childhood Cancer Survivors

et al. 2012

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Background/Aims: Gonadal dysfunction is one of the major endocrinological late effects among childhood cancer survivors (CCSs). Periodic screening evaluation of gonadotropins and sex steroids has been recommended, although it remains difficult to predict gonadal function and reproductive capacity in childhood. We evaluated the effects of cancer treatments on the ovarian function of Japanese female CCSs by measuring serum levels of anti-Müllerian hormone (AMH) and gonadotropin. Methods: This was a retrospective, cross-sectional study at a single hospital. Results: Among 53 female CCSs, 28 (53%) had a decreased AMH level, while only 16 (30%) had an increased follicle-stimulating hormone (FSH) level. AMH was low in all patients with high FSH, while FSH was not elevated in 43% of patients with a low AMH level. AMH was low in 8 of 9 patients with no breast development, 11 of 14 patients with no spontaneous menstruation, and 3 of 22 patients with regular menstrual cycles. Conclusion: Measurement of AMH concentration is useful as a marker of ovarian reserve in female CCSs for detecting primary gonadal deficiency, particularly among patients without increased gonadotropin levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Low Serum Concentrations of Anti-Müllerian Hormone Are Common in 53 Female Childhood Cancer Survivors

et al. 2012

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“…Alkylating agents and abdominal radiotherapy, in particular, can have a deleterious effect on ovarian function (9). To determine ovarian reserve, anti-Mü llerian hormone (AMH) was identified as a reliable serum marker (10).…”

Section: Introductionmentioning

confidence: 99%

Decreased ovarian function is associated with obesity in very long-term female survivors of childhood cancer

Dorp

Blijdorp

Laven³

et al. 2013

European Journal of Endocrinology

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Objective: Obesity and gonadal dysfunction are known major side effects of treatment in adult childhood cancer survivors (CCS). In the general population, obesity has a negative influence on female fertility. We aimed to evaluate whether obesity and serum insulin are associated with decreased ovarian reserve markers in CCS. Design: Retrospective single-center cohort study. Methods: Data of 191 female survivors of childhood cancer were analyzed. Median follow-up time was 18.8 (2.3-48.8) years. Outcome measures were serum anti-Mü llerian hormone (AMH) and total follicle count (FC). Potential risk factors were: BMI; body composition measures, determined by dualenergy X-ray absorptiometry (total fat percentage, lean body mass, and visceral fat percentage); and fasting insulin. Results: Lower serum AMH was found in obese subjects (b (%) K49, PZ0.007) and in subjects with fasting insulin in the highest tertile (b (%) K43, PZ0.039). Total fat percentage tends to be associated with serum AMH (b (%) K2.1, PZ0.06). Survivors in the highest tertile of insulin had significantly lower FC than survivors in the lowest tertile (b K6.3, PZ0.013). BMI and other measures of body composition were not associated with FC. Correlation between serum AMH and antral follicle count (AFC) was rZ0.32 (PZ0.08). Conclusions: Obesity and insulin resistance are associated with gonadal damage, as reflected by decreased AMH and reduced FC in adult survivors of childhood cancer. In contrast to its highly predictive value for AFC in the healthy female population, serum AMH does not seem to correlate as well with AFC in CCS.European Journal of Endocrinology 168 905-912

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“…Ovarian reserve, the number of remaining follicles in the ovary, declines naturally with age; however, researchers recently demonstrated that age alone is not an accurate indicator of reproductive age and that other factors may be implicated in the depletion of the ovarian follicle pool (van Disseldorp et al, 2008). Thus, identifying factors that contribute to the decline of ovarian reserve may aid in the prevention and early detection of follicular depletion, premature ovarian failure, and importantly impaired fertility (Lie Fong et al, 2009). …”

Section: Call-outsmentioning

confidence: 99%

Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain

Hardy¹,

McCarthy²,

Fourie³

et al. 2016

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective To explore the association of hypothalamic-pituitary-adrenal activity with ovarian functioning in women with and without chronic abdominal pain (CAP). Design and Setting A secondary data analysis was performed using data from female participants in a natural history protocol at the National Institutes of Health. Participants A total of 36 women (19 – 39 years, mean 27.11) were included in the study. Methods This pilot study was conducted using a subset of participants enrolled in a natural history protocol conducted in the Hatfield Clinical Research Center at the National Institutes of Health. The parent study included participants with and without CAP who provided a five hour urine sample for determination of cortisol levels and serum samples for determination of circulating levels of cortisol, luteinizing hormone, and follicle stimulating hormone. Chronic abdominal pain was defined as presence or absence of chronic pain for ≥ 6 months and was determined via self-report. Results Anti-Müllerian hormone (AMH) concentrations declined significantly with age as expected. When AMH levels were dichotomized as normal or abnormal (defined as higher or lower than age-specific normative ranges), there were significant associations between abnormal AMH levels and CAP and urine cortisol levels. Subjects with CAP or low urine cortisol levels were significantly more likely to have abnormal AMH levels. Conclusion Results suggest that chronic abdominal pain and hypothalamic-pituitary-adrenal dysregulation may be associated with abnormal AMH levels.

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Assessment of ovarian reserve in adult childhood cancer survivors using anti-Mullerian hormone

Cited by 163 publications

References 36 publications

Low Serum Concentrations of Anti-Müllerian Hormone Are Common in 53 Female Childhood Cancer Survivors

Low Serum Concentrations of Anti-Müllerian Hormone Are Common in 53 Female Childhood Cancer Survivors

Decreased ovarian function is associated with obesity in very long-term female survivors of childhood cancer

Anti-Müllerian Hormone Levels and Urinary Cortisol in Women With Chronic Abdominal Pain

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