title: Prediction of postchemotherapy ovarian function using markers of ovarian reserve.
abstract: BACKGROUND
  Reproductive-aged women frequently receive both chemotherapy and endocrine therapy as part of their treatment regimen for early stage hormone receptor-positive breast cancer. Chemotherapy results in transient or permanent ovarian failure in the majority of women. The difficulty in determining which patients will recover ovarian function has implications for adjuvant endocrine therapy decision making. We hypothesized that pretreatment serum anti-Müllerian hormone (AMH) and inhibin B concentrations would predict for ovarian function following chemotherapy.
  
  
  METHODS
  Pre- and perimenopausal women aged 25-50 years with newly diagnosed breast cancer were enrolled. Subjects underwent phlebotomy for assessment of serum AMH, inhibin B, follicle-stimulating hormone, and estradiol prior to chemotherapy and 1 month and 1 year following completion of treatment. Associations among hormone concentrations, clinical factors, and biochemically assessed ovarian function were assessed.
  
  
  RESULTS
  Twenty-seven subjects were evaluable for the primary endpoint. Median age was 41. Twenty subjects (74.1%) experienced recovery of ovarian function within 18 months. Of the 26 evaluable subjects assessed prior to chemotherapy, 19 (73.1%) had detectable serum concentrations of AMH. The positive predictive value of a detectable baseline serum AMH concentration for recovery of ovarian function was 94.7%, and the negative predictive value was 85.7%. On univariate analysis, younger age and detectable serum AMH concentration at chemotherapy initiation were predictive of increased likelihood of recovery of ovarian function.
  
  
  CONCLUSIONS
  Prechemotherapy assessment of serum AMH may be useful for predicting postchemotherapy ovarian function. This finding has implications for decision making about adjuvant endocrine therapy in premenopausal women treated with chemotherapy.
authors: Breast Oncology Program, University of Michigan Comprehensive Cancer Center, Department of Biostatistics, and Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
authors: N Lynn
authors: NL
authors: Henry
authors: Rong
authors: R
authors: Xia
authors: Anne F
authors: AF
authors: Schott
authors: Daniel
authors: D
authors: McConnell
authors: Mousumi
authors: M
authors: Banerjee
authors: Daniel F
authors: DF
authors: Hayes
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone
keywords: Anti-Müllerian hormone; Breast cancer; Chemotherapy; Ovarian function