title: Uses of anti-Müllerian hormone (AMH) measurement before and after cancer treatment in women.
abstract: There is a growing body of evidence supporting the use of anti-Müllerian hormone (AMH) serum levels as a biomarker of the growing follicle pool, in turn taken to reflect the ovarian reserve, in patients being treated for cancer. Many cancer therapies are gonadotoxic, often inducing premature ovarian insufficiency (POI) and thus rendering such patients infertile. The degree of ovariotoxicity is related to the type of treatment, dosage and patient's age. As survival rates from cancer improve, post-treatment reproductive health is becoming increasingly important to affected girls and women of reproductive age to allow them to have biologically-related children. AMH levels taken post-treatment may be able to guide advice regarding remaining reproductive lifespan and aid decision-making on suitable adjuvant hormonal treatments such as in hormone receptor-positive breast cancer. Furthermore, pre-treatment AMH levels are now shown to be predictive of long-term ovarian function. The development of prognostic scoring and classification methods including the use of pre-treatment AMH, as well as other patient factors including age, to determine the likelihood of return of menses may allow better individualisation of advice regarding the use of fertility preservation strategies prior to commencing cancer treatment. AMH may also be a useful marker of cancer therapy-related ovarian damage in pre-pubertal children, although there are very limited data on the relationship between AMH and the ovarian reserve in children and adolescents. AMH is proving to be of increasing value in assessing ovarian function and advising patients before and after cancer treatment.
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queens Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, Scotland, UK. Electronic address: Cheryl.dunlop@ed.ac.uk.
authors.forename: Cheryl E
authors.initials: CE
authors.lastname: Dunlop
authors.affiliation: MRC Centre for Reproductive Health, University of Edinburgh, Queens Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, Scotland, UK. Electronic address: Richard.anderson@ed.ac.uk.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Anderson
mesh_terms: D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D065851:Ovarian Reserve; D016387:Women's Health
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: Anti-Müllerian hormone; Cancer; Chemotherapy; Ovarian reserve; Premature ovarian insufficiency