title: Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding.
abstract: Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakano
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Akahoshi
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ugai
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Wada
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ishihara
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Sakamoto
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Kiriko
authors.initials: K
authors.lastname: Terasako-Saito
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Kimura
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Misato
authors.initials: M
authors.lastname: Kikuchi
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kako
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Tanihara
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Nishida
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847, Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan. ycanda-tky@umin.ac.jp.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000328:Adult; D064591:Allografts; D054304:Anti-Mullerian Hormone / Q000097:blood* / Q000502:physiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis; D019653:Myeloablative Agonists / Q000627:therapeutic use; D020380:Needs Assessment; D065851:Ovarian Reserve; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods
chemical_list: D019653:Myeloablative Agonists; D054304:Anti-Mullerian Hormone
keywords: Anti-Müllerian hormone; Fertility; Hematopoietic stem cell transplantation; Ovarian reserve; Ovarian shielding