title: Quality of life in female cancer survivors: is it related to ovarian reserve?
abstract: OBJECTIVE
  The purpose of the study is to assess the quality-of-life scores and possible association with measures of ovarian reserve in female cancer survivors compared to healthy controls of similar age.
  
  
  METHODS
  In this prospective cohort study, fifty-nine cancer survivors aged 16-39 years and 66 healthy, similarly aged unexposed women were recruited at the University of Pennsylvania. The primary outcome measures are the generic and cancer-specific domain scores on the Quality of Life in Adult Cancer Survivors (QLACS) instrument, early follicular phase serum hormones, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), inhibin B (INH), anti-Mullerian hormone (AMH), and ovarian ultrasound measurements [ovarian volume and antral follicle count (AFC)].
  
  
  RESULTS
  Cancer survivors had significantly higher total and cancer-specific domain scores compared to unexposed participants. Serum AMH, INH, ovarian volume, and AFC were lower while serum FSH was higher in cancer survivors. Although survivors exhibited diminished ovarian reserve, these markers were not independently associated with total QLACS score. Cancer survivors with irregular menstrual function were found to have lower quality-of-life (QOL) scores than those with regular cycles.
  
  
  CONCLUSIONS
  We found that QOL appears to be significantly impaired in cancer survivors compared to controls, even when remote from initial cancer diagnosis. In addition, our study suggests that reproductive aging contributes to QOL in the setting of irregular menses and likely profound impairment of ovarian function.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA, laxmi.kondapalli@ucdenver.edu.
authors.forename: Laxmi A
authors.initials: LA
authors.lastname: Kondapalli
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Dillon
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Anushree
authors.initials: A
authors.lastname: Ray
authors.forename: Maureen
authors.initials: M
authors.lastname: Prewitt
authors.forename: Jill P
authors.initials: JP
authors.lastname: Ginsberg
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006065:Gonadotropins, Pituitary / Q000097:blood; D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000503:physiopathology* / Q000523:psychology*; D010053:Ovary / Q000033:anatomy & histology / Q000502:physiology*; D011446:Prospective Studies; D011788:Quality of Life; D017741:Survivors
chemical_list: D014408:Biomarkers, Tumor; D006065:Gonadotropins, Pituitary