Association between spontaneous ovulation and serum anti‐Müllerian hormone levels in a premature ovarian insufficiency patient after a multimodal treatment for breast cancer

Wakimoto, Yu; Fukui, Atsushi; Wakimoto, Goh; Ikezawa, Yuji; Matsuoka, Michie; Omote, Maya; Sugiyama, Yukiko; Ukita, Yuji; Kato, Toru; Shibahara, Hiroaki

doi:10.1111/jog.14101

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Based on this step, 79 articles were excluded for the following reasons: outcome other than AMH, incomplete data and full text in languages other than English. One study was excluded because it reported the same sample of patients as another [ 33 ] and three studies were excluded because they included fewer than ten patients [ 34 , 35 , 36 , 37 ]. One article was additionally added after hand-searching the references of the included studies [ 8 ].…”

Section: Resultsmentioning

confidence: 99%

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Romito¹,

Bove²,

Romito³

et al. 2021

JPM

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Background: Worldwide, breast cancer (BC) is the most common malignancy in the female population. In recent years, its diagnosis in young women has increased, together with a growing desire to become pregnant later in life. Although there is evidence about the detrimental effect of chemotherapy (CT) on the menses cycle, a practical tool to measure ovarian reserve is still missing. Recently, anti-Mullerian hormone (AMH) has been considered a good surrogate for ovarian reserve. The main objective of this paper is to evaluate the effect of CT on AMH value. Methods: A systematic review and meta-analysis were conducted on the PubMed and Scopus electronic databases on articles retrieved from inception until February 2021. Trials evaluating ovarian reserves before and after CT in BC were included. We excluded case reports, case-series with fewer than ten patients, reviews (narrative or systematic), communications and perspectives. Studies in languages other than English or with polycystic ovarian syndrome (PCOS) patients were also excluded. AMH reduction was the main endpoint. Egger’s and Begg’s tests were used to assess the risk of publication bias. Results: Eighteen trials were included from the 833 examined. A statistically significant decline in serum AMH concentration was found after CT, persisting even after years, with an overall reduction of −1.97 (95% CI: −3.12, −0.82). No significant differences in ovarian reserve loss were found in the BRCA1/2 mutation carriers compared to wild-type patients. Conclusions: Although this study has some limitations, including publication bias, failure to stratify the results by some important factors and low to medium quality of the studies included, this metanalysis demonstrates that the level of AMH markedly falls after CT in BC patients, corresponding to a reduction in ovarian reserve. These findings should be routinely discussed during oncofertility counseling and used to guide fertility preservation choices in young women before starting treatment.

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Section: Resultsmentioning

confidence: 99%

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Romito¹,

Bove²,

Romito³

et al. 2021

JPM

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“…Interestingly, a case report of a patient with premature ovarian insufficiency (POI) exhibited a slight increase in AMH prior to spontaneous ovulation after chemotherapy for breast cancer, and she became pregnant 3 years later. 18 Furthermore, GCs can respond to controlled ovarian hyperstimulation in patients with POI, despite their undetectable AMH levels. 19 This phenomenon suggests that GCs surviving chemotherapy could maintain their function in ovulation.…”

Section: Discussionmentioning

confidence: 99%

After cyclophosphamide exposure, granulosa cells recover their anti‐müllerian hormone‐producing ability but not their numbers

Kim

You

2020

Cytometry Pt A

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Anti‐müllerian hormone (AMH) produced by granulosa cells (GCs), reserves the ovarian follicle pool for future recruitment and ovulation. However, women who have undergone cyclophosphamide (Cy) treatment have decreased AMH levels due to damaged GCs. This study establishes flow cytometry protocols for identification of GCs and investigates the cause of the Cy‐induced AMH decrease by analyzing the number of GCs and their AMH production at the single cell level. Over 2 weeks, C57BL/6 mice were intraperitoneally injected 6 times with 100 mg/kg Cy and sacrificed either immediately or 4 weeks after Cy treatment. Twenty‐four hours post‐Cy exposure, a decrease in serum AMH levels was seen due to a reduction in the number of follicle‐stimulating hormone receptor (FSHR)+AMH+ GCs and their ability to produce AMH. However, 4 weeks after Cy treatment, serum AMH levels were still decreased due to the decreased number of FSHR+AMH+ GCs, however, their AMH‐producing ability was unaltered. Consistently, in vitro, Cy‐induced low AMH production in FSHR+AMH+ hGL5 cells (immortalized human GCs) was restored 24 h after Cy treatment, although their numbers remained decreased. Thus, the surviving GCs after Cy exposure had intact AMH‐producing ability. In future, an effort to minimize GC death by Cy treatment is required, while maintaining its therapeutic effects.

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Cyclophosphamide/docetaxel

2019

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Association between spontaneous ovulation and serum anti‐Müllerian hormone levels in a premature ovarian insufficiency patient after a multimodal treatment for breast cancer

Cited by 4 publications

References 17 publications

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

After cyclophosphamide exposure, granulosa cells recover their anti‐müllerian hormone‐producing ability but not their numbers

Cyclophosphamide/docetaxel

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