Assessment of ovarian reserve with anti-Mullerian hormone in women following allogeneic hematopoietic cell transplantation

Abstract

Introduction: Severe ovarian failure and persistent infertility have could be seen in females following allogeneic hematopoietic cell transplantation (allo-HCT.) In this study, the authors aimed to determine the effectiveness of AMH on assessment of ovarian reserve in long-term survivors after allo-HCT. Material and Methods: Female patients, who underwent allo-HCT between August 2009 and February 2016, were retrospectively evaluated for ovarian capacity in long-term follow-up. Twenty-one female patients with a median age of 34 (22-45) years were included in the study. The serum levels of estrogen (E2), follicle stimulated hormone (FSH), luteinizing hormone (LH), and AMH were analysed. Results: The median duration of post-transplant follow-up was 37 (12-84) months. Primary ovarian failure (POF) was detected in eight (38,1%) and 19 (90,4%) cases in the pre-transplant and post-transplant period, respectively. It was found that no menstruation cycles were observed in 18 cases with low AMH levels. Discussion: Regular menstrual cycles may not guarantee the fertilization in the post-transplant period. Combined analysis of hormonal investigations, antral follicle count by vaginal USG, and evaluation of serum AMH levels may be preferred to demonstrate the presence of POF.