Cross-sectional and prospective study on anti-Müllerian hormone changes in a cohort of pre-menopausal women with a history of differentiated thyroid cancer

Abstract

Background: Anti-Müllerian hormone (AMH) decreases acutely after post-surgical radioactive iodine (RAI) ablation in females with differentiated thyroid cancer (DTC). Aim: We performed a cross-sectional and prospective study on AMH levels in pre-menopausal females with a history of DTC. Methods: Fifty-nine females after surgery and RAI (group 1) and 30 females after surgery alone (group 2) were studied. The control group consisted of 141 healthy women (group 3). The prospective study was performed in 43 and 14 females from groups 1 and 2, respectively. Results: On first evaluation, AMH levels were similar in groups 1 and 2, but lower than in group 3. In all groups, AMH was negatively related with chronological age and FSH levels. When subjects were stratified according to age, AMH levels were not different between groups. When AMH was evaluated up to 2 years after the baseline evaluation, no changes emerged in either group of women with DTC. In the prospective study, the incidence of abnormal menstrual cycles and the onset of menopause were observed in similar percentages of women with a history of RAI-treated DTC and of those treated with surgery alone. Conclusions: AMH can be considered a reliable index of ovarian reserve in women with DTC. Chronological age is the main factor influencing AMH levels in both DTC patients and controls. After age-related stratification, AMH levels are similar in women with DTC treated with RAI and those treated with surgery alone.

The Effect of Radioactive Iodine Therapy on Ovarian Function and Fertility in Female Thyroid Cancer Patients: A Systematic Review and Meta-Analysis

“…They found that AMH levels were only negatively correlated with age in the treatment group (rS -0.58; p = 0.0003) and in the control group (rS -0.81 p < 0.0001). Mittica et al performed a cross-sectional study comparing 59 women who underwent surgery and RAI for DTC, 30 women only receiving surgery and 141 healthy women (23). In this study, the main factor for lower AMH levels was also age and not the type of treatment.…”

“…Seven studies examined the effect of RAI treatment on the ovarian reserve by assessing AMH levels after RAI treatment (Table 3) (9)(10)(11)(12)(13)22,23). Yaisch et al studied 30 women with DTC whom received RAI doses ranging from 1110 to 5550 MBq (30 to 150 mCi) after recombinant human thyrotropin stimulation.…”

Is Supplementation with Micronutrients Still Necessary during Pregnancy? A Review

“…Several studies have shown that, in certain complications associated with pregnancy, such as gestational diabetes or pre-eclampsia, there is an increase in oxidative stress. Faced with this situation, the body responds by enhancing its antioxidant mechanisms, some of which lie in the diet [ 156 , 157 ]. Selenium deficiency is also associated with an increased risk of miscarriage.…”

Assessment of different markers of ovarian reserve in women with papillary thyroid cancer treated with radioactive iodine

“…Interestingly, Mittica et al observed a non-significant reduction in AMH on ANOVA testing in women treated with RAI and in women after thyroidectomy. However, on applying Wilcoxon’s paired test, AMH significantly decreased between the first and second evaluations only in women treated with RAI, with no significant variations observed between the first and second determination in groups after thyroidectomy ( 22 ).…”