title: Limited value of ovarian function markers following orthotopic transplantation of ovarian tissue after gonadotoxic treatment.
abstract: BACKGROUND
  In young women, some treatments for cancer or other conditions (such as sickle cell anemia) may give rise to primary ovarian insufficiency. Ovarian transplantation is one of the available options for fertility preservation, with highly variable pregnancy rates.
  
  
  OBJECTIVE
  The objective of the study was to investigate markers of ovarian reserve and ovarian function in women up to 7 yr after orthotopic ovarian transplantation. Secondary objectives were to assess the relationship between markers of ovarian reserve and pregnancy rate along with the duration of ovarian function.
  
  
  METHODS
  This was a prospective cohort study in 10 women, with a mean follow-up of 2.5 yr.
  
  
  METHODS
  The study was conducted at a university hospital in Brussels, Belgium.
  
  
  METHODS
  Patients included 10 women who were about to receive or had previously received gonadotoxic treatment. In seven women cryopreservation of ovarian tissue was performed before starting treatment. Subsequently autografts were orthotopically transplanted in these women. Three women, who had already developed primary ovarian insufficiency due to treatment, underwent orthotopic transplantation of ovarian allograft tissue originating from their human leukocyte antigen-compatible sisters.
  
  
  METHODS
  Serum concentrations of FSH, LH, estradiol, inhibin B, and anti-Müllerian hormone (AMH) were measured.
  
  
  RESULTS
  On average, first menses took place after 4.7 months. Duration of graft functioning varied from 2 to more than 60 months. FSH concentrations remained elevated, whereas estradiol levels normalized and AMH was low to undetectable. Inhibin B varied among women and was not associated with the duration of ovarian function (hazard ratio 0.966, 95% confidence interval 0.881-1.059). Two spontaneous pregnancies occurred. Endocrine characteristics were not significantly different in these women.
  
  
  CONCLUSIONS
  Low AMH and inhibin B concentrations may suggest decreased ovarian reserve in women after ovarian transplantation. AMH and inhibin B levels may not be associated with the duration of ovarian graft function or probability to achieve a pregnancy.
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. f.janse@umcutrecht.nl
authors.forename: Femi
authors.initials: F
authors.lastname: Janse
authors.forename: Jacques
authors.initials: J
authors.lastname: Donnez
authors.forename: Ellen
authors.initials: E
authors.lastname: Anckaert
authors.forename: Frank H
authors.initials: FH
authors.lastname: de Jong
authors.forename: Bart C J M
authors.initials: BC
authors.lastname: Fauser
authors.forename: Marie-Madeleine
authors.initials: MM
authors.lastname: Dolmans
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000032:analysis / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis*; D015925:Cryopreservation; D004958:Estradiol / Q000032:analysis / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000032:analysis / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control; D007265:Inhibins / Q000032:analysis / Q000097:blood; D010053:Ovary / Q000502:physiology* / Q000637:transplantation*; D011237:Predictive Value of Tests; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced* / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D016042:Transplantation, Heterotopic; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone