Self-collected dried blood spots as a tool for measuring ovarian reserve in young female cancer survivors

Roberts, Samantha C.; Seav, Susan M.; McDade, Thomas W.; Dominick, Sally A.; Gorman, Jessica R.; Whitcomb, Brian W.; Su, H. Irene

doi:10.1093/humrep/dew114

Cited by 26 publications

(30 citation statements)

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“…For instance, in a study conducted by Fokkema and colleagues with an adult sample of diabetics who received in-person training on the self-collection of DBS, 95% of samples were collected correctly [11]. Our laboratory staff determined 92-96% of our samples were collected correctly, which was slightly higher than the 91% observed in recently published work that used written training materials only [4]. Further, prior literature on self-collection of DBS that used inperson training reported high rates of willingness to self-collect DBS again (e.g., 93% in a sample of HIV-infected individuals [10].…”

Section: Discussionmentioning

confidence: 56%

“…Nonresponders were younger and more likely to be non-White. Our response rate is quite a bit lower than that observed among a recently completed project with young adult cancer survivors, which paid participants $20 for completion [4]. It is likely that young adult cancer survivors are more motivated to participate in research than young adult smokers in the general population.…”

Section: Discussionmentioning

confidence: 66%

“…A wide range of biomarkers have been validated for assessment using DBS (Table 1) [1][2][3][4][5][6], with the number surpassing the number of validated biomarkers in urine or saliva samples alone [1,7]. The use of DBS in biomedical research has been growing as it allows objective measurement of variables that have been troubled by self-report and recall bias (e.g., biological confirmation of smoking status or medication compliance) [1].…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, the use of this methodology is limited as nearly all studies have relied on in-person training for self-collection of DBS. However, Roberts and colleagues [4] recently utilized the self-collection of DBS after training via a printed brochure that was delivered through the mail. While 91% of their samples were useable, they recommended the use of a training video to reduce the number of suboptimal DBS specimens.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Web-Delivered Multimedia Training Materials for the Self-Collection of Dried Blood Spots: A Formative Project (Preprint)

Allen¹,

Lundeen²,

Murphy³

et al. 2018

Preprint

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Web-Delivered Multimedia Training Materials for the Self-Collection of Dried Blood Spots: A Formative Project (Preprint)

Allen¹,

Lundeen²,

Murphy³

et al. 2018

Preprint

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“…At least a third of women who receive a diagnosis of DTC are less than 45 years old and want to know whether their cancer treatment will contribute to the natural decline of their ovarian reserve. Roberts et al [21] studied AMH in young females who were survivors from various cancers, including a large cohort of subjects with a history of thyroid/skin cancer. They documented a wide range of AMH levels, from 3.5 pmol/l to 29.8 pmol/l, which was regarded as a reference range because, in these cancers, therapies were not thought to be toxic to ovaries [21].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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Perceived and Objective Fertility Risk Among Female Survivors of Adolescent and Young Adult Cancer

Din,

Singh-Carlson,

Corliss

et al. 2023

JAMA Netw Open

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ImportanceFertility is important to many survivors of adolescent and young adult (AYA) cancer, yet data on this population’s fertility perceptions and their alignment with objective infertility risk are scant.ObjectiveTo assess whether estimated treatment gonadotoxicity and posttreatment menstrual pattern are associated with higher infertility risk perception.Design, Setting, and ParticipantsThis retrospective cohort study included female young adult survivors of cancer diagnosed between ages 15 and 39 years were recruited between March 25, 2015, and September 24, 2018, from 2 state cancer registries, social media, and clinician referrals to participate in a study of posttreatment ovarian function. Data analysis occurred between March 1 and September 1, 2022.ExposuresParticipants reported their menstrual pattern. Estimated treatment gonadotoxicity was ascertained through medical record review.Main Outcomes and MeasuresParticipants reported infertility risk perception and were categorized as increased risk (feeling less fertile or unable to become pregnant) or no increased risk (feeling more or as fertile) compared with female individuals their age. Objective infertility risk was determined by estimated gonadotoxicity, menstrual pattern, and ovarian reserve testing of self-collected dried blood spots. Multivariable logistic regression identified factors associated with perceived infertility and underestimation or overestimation of infertility risk.ResultsThis study included 785 female participants with a mean (SD) age of 33.2 (4.8) years at enrollment and 25.9 (5.7) years at diagnosis. Most participants self-identified their race and ethnicity as White (585 [74.5%]) and non-Hispanic (628 [78.7%]). Most participants (483 [61.5%]) perceived a higher risk of infertility compared with female participants their age. Prior exposure to moderate- or high-gonadotoxicity treatments was associated with higher odds of perceiving increased infertility risk compared with exposure to low-gonadotoxicity treatments (adjusted odds ratio [AOR], 2.73 [95% CI, 1.87-3.97] and 15.39 [95% CI, 5.52-42.96], respectively). Amenorrhea and irregular cycles were associated with higher odds of perceiving increased infertility risk (AOR, 3.98 [95% CI, 2.13-7.41] and 1.69 [95% CI, 1.19-2.40], respectively). Perceived infertility risk had minimal agreement with objective risk (κ = 0.19). Multiparity (AOR, 4.17 [95% CI, 2.61-6.64]) was associated with increased odds of underestimation, while older age (AOR, 0.94 [95% CI, 0.89-0.98]), endocrine comorbidity (AOR, 0.35 [95% CI, 0.18-0.69]), and prior infertility (AOR, 0.16 [95% CI, 0.07-0.38]) were associated with lower odds of underestimation. Multiparity (AOR, 0.48 [95% CI, 0.27-0.86]), breast cancer (AOR, 0.38 [95% CI, 0.20-0.73]), and skin cancer (AOR, 0.24 [95% CI, 0.11-0.51]) were associated with lower odds of overestimation.Conclusions and RelevanceIn this cohort study, survivors of AYA cancer had high rates of perceiving increased infertility risk but frequently overestimated or underestimated their risk. These findings suggest that counseling on infertility risk throughout survivorship may reduce misalignment between perceptions and actual risk, decrease fertility-related psychological distress, and inform family planning decisions.

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Self-collected dried blood spots as a tool for measuring ovarian reserve in young female cancer survivors

Abstract: Research related to the development of this paper was supported by the National Institutes of Health, grants UL1 RR024926 pilot and HD080952-02, and by the American Cancer Society MRSG-08-110-01-CCE. The authors report no competing interests.

Cited by 26 publications

References 50 publications

Web-Delivered Multimedia Training Materials for the Self-Collection of Dried Blood Spots: A Formative Project (Preprint)

Web-Delivered Multimedia Training Materials for the Self-Collection of Dried Blood Spots: A Formative Project (Preprint)

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

Perceived and Objective Fertility Risk Among Female Survivors of Adolescent and Young Adult Cancer

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