title: Menstrual patterns, fertility and main pregnancy outcomes after allogeneic haematopoietic stem cell transplantation.
abstract: Two-hundred and sixty-nine females aged ≤42 and undergoing an allogeneic stem cell transplant were retrospectively studied to assess the effect of age, conditioning regimen and chronic graft-versus-host disease (cGVHD) on resumption of stable menstrual cyclicity. Overall, a stable menstrual cyclicity was observed in 22% of cases. The cumulative probability of menses resumption was significantly age and conditioning regimen related. A statistically significant inverse correlation between cGVHD severity and menses resumption was observed only in univariate analysis. In patients with residual ovarian function, infertility was found in 43% and early menopause in 45%. An increased incidence of prematurity and low birth weight (LBW) was observed among the single spontaneous pregnancies. Follicle-stimulating hormone (FSH) and 17 beta-oestradiol levels were found to be inadequate to detect both early signs of menses resumption and menstrual stability. Our study confirms the crucial role of full dose total body irradiation (TBI) and age on menses recovery and fertility after haematopoietic stem cell transplantation (HSCT). The impact of severe cGVHD remains unclear.
authors.affiliation: a Hematology Department , IRCCS San Martino-IST , Genoa, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Chiodi
authors.affiliation: a Hematology Department , IRCCS San Martino-IST , Genoa, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Spinelli
authors.affiliation: b Clinical Epidemiology, IRCCS San Martino-IST , Genoa, Italy , and.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bruzzi
authors.affiliation: c Physiopathology of Reproduction Unit, IRCCS San Martino-IST , Genoa , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Anserini
authors.affiliation: a Hematology Department , IRCCS San Martino-IST , Genoa, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Di Grazia
authors.affiliation: a Hematology Department , IRCCS San Martino-IST , Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
mesh_terms: D000328:Adult; D000367:Age Factors; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility; D005640:Follicle Stimulating Hormone / Q000097:blood; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007246:Infertility / Q000209:etiology; D008597:Menstrual Cycle; D008599:Menstruation Disturbances / Q000097:blood / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods
chemical_list: D004958:Estradiol; D005640:Follicle Stimulating Hormone
keywords: 17 beta-oestradiol; Haematopoietic stem cell transplantation; fertility; follicle-stimulating hormone; graft-versus-host disease; menstrual patterns