Ovarian reserve in women who remain premenopausal after chemotherapy for early stage breast cancer.
OBJECTIVE
To compare markers of ovarian reserve between women exposed to cytotoxic chemotherapy for early stage breast cancer and matched controls.


METHODS
Cross-sectional evaluation of markers of ovarian reserve.


METHODS
Dana-Farber/Brigham and Women's Cancer Center, Massachusetts General Hospital, and Faulkner Hospital in Boston, MA.


METHODS
Breast cancer survivors with continued menses after chemotherapy were compared with age-matched, gravidity-matched controls.


METHODS
Antral follicle count (AFC), anti-Müllerian hormone (AMH), FSH, inhibin B (InB), and E(2) on day 2, 3, or 4 of the menstrual cycle. A Bonferroni correction was performed to correct for multiple comparisons.


RESULTS
Twenty survivors and 20 controls were evaluated; 50% of survivors were currently on tamoxifen. Median AFC was 6 for survivors and 9.5 for controls. There were significant differences between the two groups in AFC, AMH, and nonsignificant differences in FSH and InB, all indicating better ovarian reserve in controls. The AFC and AMH levels were highly correlated (r = 0.72). Survivors on tamoxifen had lower AFC, AMH, InB, and higher E(2) than nontamoxifen-treated survivors.


CONCLUSIONS
Premenopausal breast cancer survivors have diminished ovarian reserve compared with controls.
Partridge
Ann H
AH
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA 02115, USA. ahpartridge@partners.org
Ruddy
Kathryn J
KJ
Gelber
Shari
S
Schapira
Lidia
L
Abusief
Mary
M
Meyer
Meghan
M
Ginsburg
Elizabeth
E
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D007265:Inhibins / Q000097:blood; D008499:Medical Records; D008597:Menstrual Cycle; D009367:Neoplasm Staging; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology*; D017697:Premenopause; D017741:Survivors / Q000706:statistics & numerical data; D013629:Tamoxifen / Q000009:adverse effects*
D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; C422364:inhibin B; D013629:Tamoxifen; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone