title: Anti-Müllerian hormone as a marker of ovarian reserve following chemotherapy in patients with gestational trophoblastic neoplasia.
abstract: OBJECTIVE
  The loss of primordial follicles from gonadal damage caused by chemotherapy results in decreased ovarian reserve. To assess the impact of chemotherapy for patients with gestational trophoblastic neoplasia (GTN) on the ovarian reserve, we evaluated the post-chemotherapy serum anti-Müllerian hormone (AMH) levels.
  
  
  METHODS
  In 22 patients with GTN receiving chemotherapy, serum AMH levels were measured after the administration of chemotherapy and compared with serum AMH levels measured in patients with hydatidiform mole who did not receive chemotherapy, as a control. We also analyzed differences in the serum AMH levels following the administration of different anti-cancer agents.
  
  
  RESULTS
  The serum AMH levels measured in the GTN group after chemotherapy was administered (median 1.18, range 0.32-3.94 ng/mL) significantly decreased in comparison to those measured in the control group (median 4.22, range 0.77-6.53 ng/mL, P=0.002). Serum AMH levels were significantly lower in the patients who had received a regimen including etoposide than in the patients who had not received treatment with etoposide (0.71 vs. 1.30 ng/mL, P=0.027).
  
  
  CONCLUSIONS
  Our results suggest that chemotherapy administered to treat GTN does indeed affect the ovarian reserve, especially in patients who receive a medication regimen that includes etoposide. Measuring their serum AMH levels might therefore be helpful for counseling GTN patients regarding their ovarian reserve.
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan. akiwase@med.nagoya-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Iwase
authors.forename: Atsuko
authors.initials: A
authors.lastname: Sugita
authors.forename: Wakana
authors.initials: W
authors.lastname: Hirokawa
authors.forename: Maki
authors.initials: M
authors.lastname: Goto
authors.forename: Eiko
authors.initials: E
authors.lastname: Yamamoto
authors.forename: Sachiko
authors.initials: S
authors.lastname: Takikawa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakahara
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakamura
authors.forename: Mika
authors.initials: M
authors.lastname: Kondo
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D003609:Dactinomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004107:Dilatation and Curettage; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D031901:Gestational Trophoblastic Disease / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006828:Hydatidiform Mole / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010053:Ovary / Q000187:drug effects* / Q000503:physiopathology; D011247:Pregnancy; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D003609:Dactinomycin; D005047:Etoposide; D054304:Anti-Mullerian Hormone; D008727:Methotrexate