title: Age, anti-müllerian hormone, antral follicles count to predict amenorrhea or oligomenorrhea after chemotherapy with cyclophosphamide.
abstract: BACKGROUND
  A cohort study was performed to identify ovarian reserve markers (ORM) that predicts amenorrhea or oligomenorrhea 6 months after cyclophosphamide CTX in women with breast cancer.
  
  
  METHODS
  52 eumenorrheic patients with breast cancer were enrolled. FSH, anti-Müllerian hormone (AMH), antral follicles count (AFC) were measured before and 6 months after CTX. A logistic regression for independent samples and determination of the ROC curve were performed.
  
  
  RESULTS
  The age of 32 years presented 96 % of sensitivity and 39 % of specificity to predict amenorrhea or oligomenorrhea with ROC area under the curve (AUC) of 0.77. ovarian reserve marker (ORM) with power to predict amenorrhea or oligomenorrhea in women after CTX were AMH <3.32 ng/mL (sensitivity of 85 %, specificity of 75 % and AUC 0.87), AFC <13 follicles (sensitivity 81 %, specificity 62 %, AUC 0.81). AMH cutoff to predict amenorrhea was 1.87 ng/mL (sensitivity 82 %, specificity 83 %, AUC 0.84) and AFC cutoff was 9 follicles (sensitivity 71 %, specificity 78 %, AUC 0.73).
  
  
  CONCLUSIONS
  ≥32-years-old women, AMH <3.32 ng/mL and AFC <13 follicles determined significantly higher risk of amenorrhea or oligomenorrhea after CTX with cyclophosphamide. The ORM age (≥32 years) analyzed together with AMH or AFC increases sensitivity and specificity in predicting amenorrhea or oligomenorrhea.
authors.affiliation: Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul School of Medicine, Bento Gonçalves, RS, Brazil. angelamdavila@yahoo.com.br.
authors.forename: Ângela Marcon
authors.initials: ÂM
authors.lastname: D'Avila
authors.affiliation: Graduate Program in Biological Sciences: Physiology, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Lajeado, RS, Brazil. vbiolchi@gmail.com.
authors.forename: Vanderlei
authors.initials: V
authors.lastname: Biolchi
authors.affiliation: Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul School of Medicine, Bento Gonçalves, RS, Brazil. edcapp@ufrgs.br.|Graduate Program in Biological Sciences: Physiology, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Lajeado, RS, Brazil. edcapp@ufrgs.br.|Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, Sul School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. edcapp@ufrgs.br.|Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital Heidelberg, Heidelberg, Germany. edcapp@ufrgs.br.|Serviço de Ginecologia e Obstetrícia - Hospital de Clínicas de Porto Alegre Rua Ramiro Barcelos, 2350/11° andar, Porto Alegre, CEP 90035-903, RS, Brazil. edcapp@ufrgs.br.
authors.forename: Edison
authors.initials: E
authors.lastname: Capp
authors.affiliation: Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul School of Medicine, Bento Gonçalves, RS, Brazil. hcorleta@gmail.com.|Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre, Sul School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. hcorleta@gmail.com.|GENERAR, Porto Alegre, RS, Brazil. hcorleta@gmail.com.
authors.forename: Helena von Eye
authors.initials: Hv
authors.lastname: Corleta
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000568:Amenorrhea / Q000139:chemically induced / Q000175:diagnosis*; D054304:Anti-Mullerian Hormone / Q000378:metabolism*; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy; D003520:Cyclophosphamide / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009839:Oligomenorrhea / Q000139:chemically induced / Q000175:diagnosis*; D006080:Ovarian Follicle / Q000187:drug effects*; D018570:Risk Assessment
chemical_list: D018906:Antineoplastic Agents, Alkylating; D054304:Anti-Mullerian Hormone; D003520:Cyclophosphamide