title: Impact of breast cancer chemotherapy on ovarian reserve: a prospective observational analysis by menstrual history and ovarian reserve markers.
abstract: OBJECTIVE
  To determine whether addition of taxanes to anthracycline and cyclophosphamide regimens impact ovarian function as assessed by menstrual history and ovarian reserve markers.
  
  
  METHODS
  Prospective observational analysis.
  
  
  METHODS
  Large university fertility center.
  
  
  METHODS
  Forty-five women with a history of breast cancer of stages I-IIIA who either received anthracycline, cyclophosphamide, and paclitaxel (ACT) or received anthracycline with cyclophosphamide (AC).
  
  
  METHODS
  Menstrual histories were obtained at 6 months and at a mean of 28 months after chemotherapy. Early follicular phase FSH and E(2) samples were obtained at the second follow-up.
  
  
  METHODS
  Incidence of amenorrhea and abnormal laboratory values.
  
  
  RESULTS
  There was no statistically significant difference in the rates of amenorrhea at 6 months after chemotherapy (AC group, 41.7%; ACT group, 29%). At the second follow-up, a mean of 28 months after chemotherapy, there was a trend toward higher amenorrhea in the ACT patients (35.7%, vs. 9.1% in the AC group). When the ovarian markers were included, an additional eight menstruating patients were identified with abnormally elevated FSH or E(2) levels.
  
  
  CONCLUSIONS
  We found no significant long- or short-term impact of taxanes on rates of amenorrhea. Future studies on the reproductive effects of chemotherapeutic agents should incorporate ovarian reserve markers, because menstrual history alone may underestimate the impact of these cytotoxic agents.
authors.affiliation: Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York Presbyterian Weill Cornell Medical Center, New York, New York 10021, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Reh
authors.forename: Ozgur
authors.initials: O
authors.lastname: Oktem
authors.forename: Kutluk
authors.initials: K
authors.lastname: Oktay
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D008598:Menstruation / Q000187:drug effects*; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D018943:Anthracyclines; D015415:Biomarkers; D004958:Estradiol; D003520:Cyclophosphamide; D005640:Follicle Stimulating Hormone; D017239:Paclitaxel