TY - JOUR
T1 - Dynamics and mechanisms of chemotherapy-induced ovarian follicular depletion in women of fertile age
AU - Rosendahl, Mikkel
AU - Andersen, Claus Yding
AU - la Cour Freiesleben, Nina
AU - Juul, Anders
AU - Løssl, Kristine
AU - Andersen, Anders Nyboe
AU - Løssl, Kristine
N1 - Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2010/6/1
Y1 - 2010/6/1
N2 - Objective: To study ovarian follicular dynamics during chemotherapy to understand the mechanisms behind chemotherapy-induced ovarian follicular depletion and to evaluate whether pretreatment levels of ovarian reserve markers were predictive of the posttreatment levels. Design: Prospective clinical study. Setting: University hospital fertility center. Patient(s): Seventeen women (median age 30 years; range 19-35 years) undergoing chemotherapy. Intervention(s): Patients were seen before, frequently during, and after chemotherapy, until 1 year after the end of treatment. Antral follicle count and levels of FSH, LH, E2, anti-Müllerian hormone (AMH), and inhibin A and B were monitored at each visit. Main Outcome Measure(s): The dynamics of the ovarian reserve markers during chemotherapy and factors predictive of posttreatment ovarian function. Result(s): Anti-Müllerian hormone level (mean ± 2 SEM) dropped from 2.7 ± 1.0 to 1.1 ± 0.6 and to 0.4 ± 0.4 ng/mL immediately after one and two series of chemotherapy, respectively. Inhibin B and antral follicle count decreased after three series whereas FSH reached menopausal levels after four series. High pretreatment AMH levels predicted higher posttreatment AMH levels. Conclusion(s): Anti-Müllerian hormone and inhibin B levels immediately declined in response to chemotherapy, and the follicular target of chemotherapy appeared to be growing follicles. High pretreatment AMH levels were predictive of a higher posttreatment AMH level.
AB - Objective: To study ovarian follicular dynamics during chemotherapy to understand the mechanisms behind chemotherapy-induced ovarian follicular depletion and to evaluate whether pretreatment levels of ovarian reserve markers were predictive of the posttreatment levels. Design: Prospective clinical study. Setting: University hospital fertility center. Patient(s): Seventeen women (median age 30 years; range 19-35 years) undergoing chemotherapy. Intervention(s): Patients were seen before, frequently during, and after chemotherapy, until 1 year after the end of treatment. Antral follicle count and levels of FSH, LH, E2, anti-Müllerian hormone (AMH), and inhibin A and B were monitored at each visit. Main Outcome Measure(s): The dynamics of the ovarian reserve markers during chemotherapy and factors predictive of posttreatment ovarian function. Result(s): Anti-Müllerian hormone level (mean ± 2 SEM) dropped from 2.7 ± 1.0 to 1.1 ± 0.6 and to 0.4 ± 0.4 ng/mL immediately after one and two series of chemotherapy, respectively. Inhibin B and antral follicle count decreased after three series whereas FSH reached menopausal levels after four series. High pretreatment AMH levels predicted higher posttreatment AMH levels. Conclusion(s): Anti-Müllerian hormone and inhibin B levels immediately declined in response to chemotherapy, and the follicular target of chemotherapy appeared to be growing follicles. High pretreatment AMH levels were predictive of a higher posttreatment AMH level.
U2 - 10.1016/j.fertnstert.2009.02.043
DO - 10.1016/j.fertnstert.2009.02.043
M3 - Journal article
SN - 1546-2501
VL - 94
SP - 156
EP - 166
JO - Sexuality, Reproduction and Menopause
JF - Sexuality, Reproduction and Menopause
IS - 1
ER -