Ovarian function after cancer treatment in young women affected by Hodgkin disease (HD).
We have evaluated the best method to assess the ovarian reserve and the ovarian protective effect of GnRH-analog (GnRH-a), in 29 women with Hodgkin's disease (HD) treated with chemotherapy (CHT). The ovarian reserve was studied by measuring the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, antimullerian hormone (AMH) and the ultrasound antral follicular count (AFC). The patients were randomly treated with or without GnRH-a. At the time of study menstrual function was normal in 21 cases (72.4%), but absent in 8 (27.5%). Mean basal values of FSH, LH, AMH, inhibin B and AFC were normal in patients less than 30 years old and in the group treated four years or less before observation. AFC appeared to be the best marker of reduced ovarian reserve and a combination of AFC-AMH or inhibin B appeared the best predictor. In the GnRH-a group, no women had amenorrhoea, although ovarian reserve assessment was not significantly different from those who were not treated. The time-interval from CHT was the only significant predictor of ovarian function in GnRH-a treated patients. In conclusion, ovarian reserve evaluation, in young patients treated by CHT, can be performed by AFC. GnRH-a treatment does not have a protective effect, but could delay the development of ovarian failure.
Giuseppe
Loverro
L
Department of Obstetric and Gynecology, University of Bari, Policlinico of Bari, Italy.
Attilio
Guarini
G
Edoardo
Di Naro
DN
Loredana
Giacomantonio
G
Cristina
Lavopa
L
Vincenzo
Liso
L
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000097:blood / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control; D054304:Anti-Mullerian Hormone; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006023:Glycoproteins / Q000097:blood; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control; D007265:Inhibins / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008466:Mechlorethamine / Q000008:administration & dosage / Q000009:adverse effects; D006080:Ovarian Follicle / Q000000981:diagnostic imaging*; D010053:Ovary / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000139:chemically induced / Q000503:physiopathology* / Q000517:prevention & control; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D012680:Sensitivity and Specificity; D017741:Survivors; D013735:Testicular Hormones / Q000097:blood; D013997:Time Factors; D017329:Triptorelin Pamoate / Q000627:therapeutic use*; D014463:Ultrasonography; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D006023:Glycoproteins; D013735:Testicular Hormones; C422364:inhibin B; D003561:Cytarabine; D017329:Triptorelin Pamoate; D001761:Bleomycin; D011344:Procarbazine; D008466:Mechlorethamine; D007265:Inhibins; D014750:Vincristine; D014747:Vinblastine; D003606:Dacarbazine; D003907:Dexamethasone; D004317:Doxorubicin; D054304:Anti-Mullerian Hormone; D003520:Cyclophosphamide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D011239:Prednisolone; D002945:Cisplatin; D011241:Prednisone