title: Clinical and biologic evaluation of ovarian function in women treated by bone marrow transplantation for various indications during childhood or adolescence.
abstract: OBJECTIVE
  To evaluate which factors determine premature ovarian failure after bone marrow transplantation (BMT) during childhood and adolescence.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Academic teaching hospital.
  
  
  METHODS
  Thirty-five women with previous allogeneic (n = 19) or autologous (n = 16) BMT for benign (n = 12) or malignant disease (n = 23). Mean age at BMT was 9.8 ± 5.2 years. Eighteen patients had received total body irradiation (TBI). Twenty-three (66%) were premenarchal at the time of BMT.
  
  
  METHODS
  Evaluation of ovarian function.
  
  
  METHODS
  Retrospective analysis of gynecologic history and hormone measurements (FSH, E(2), and antimüllerian hormone [AMH]) in relation to initial pathology, treatment protocols, age, and menarchal status at the time of BMT and time elapsed since BMT.
  
  
  RESULTS
  Clinical evidence of persistent ovarian function after BMT was found in 46% of patients (16/35), but low AMH concentrations (<1.2 μg/L) were observed in 85% of patients, including a large subset (2/3) of clinically eugonadal subjects. Age ≤10 years at the time of BMT and absence of TBI were significantly and independently associated with higher rates of clinically proven persistent ovarian function at the time of evaluation.
  
  
  CONCLUSIONS
  After BMT, ovarian function is impaired in the majority of women, even without clinical signs of premature ovarian failure. This impairment is mostly related to older age at the time of treatment and conditioning treatment with TBI.
authors.affiliation: Unité de Recherche GYNE, Department of Gynecology, Institut de Recherche Experimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium. pascale.jadoul@uclouvain.be
authors.forename: Pascale
authors.initials: P
authors.lastname: Jadoul
authors.forename: Ellen
authors.initials: E
authors.lastname: Anckaert
authors.forename: Ann
authors.initials: A
authors.lastname: Dewandeleer
authors.forename: Mélanie
authors.initials: M
authors.lastname: Steffens
authors.forename: Marie-Madeleine
authors.initials: MM
authors.lastname: Dolmans
authors.forename: Christiane
authors.initials: C
authors.lastname: Vermylen
authors.forename: Johan
authors.initials: J
authors.lastname: Smitz
authors.forename: Jacques
authors.initials: J
authors.lastname: Donnez
authors.forename: Dominique
authors.initials: D
authors.lastname: Maiter
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D010053:Ovary / Q000502:physiology* / Q000528:radiation effects; D016649:Primary Ovarian Insufficiency / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D014916:Whole-Body Irradiation / Q000009:adverse effects; D055815:Young Adult