title: Antral Follicles Count and Anti-Müllerian Hormone Levels after Gonadotoxic Chemotherapy in Patients with Breast Cancer: Cohort Study.
abstract: AimTo assess ovarian reserve (OVR) by means of follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), and antral follicle count (AFC) measurement in eumenorrheic women with breast cancer, exposed to gonadotoxic chemotherapy.MethodFifty-two women (35.3 ± 3.8 years old) with breast cancer and undergoing cyclophosphamide-containing chemotherapy were enrolled. The assessment was performed before chemotherapy (T1) and after 2 (T2) and 6 months (T3).ResultsSix months after chemotherapy, the prevalence of regular cycles was 60%. Anti-Müllerian hormone decreased down to undetectable levels at T2 and T3 (T1: 2.53 [1.00-5.31]; T2 < 0.08; T3: < 0.08 [< 0.08-1.07] ng/mL), (p< 0.0001). Antral follicle count was 11 [8.0-13.5] follicles at T1 and lower at T2 (5.50 [3.75-8.0] and T3 (5.0 [2.5-7.0]) (p< 0.0001). In patients who remained with regular cycles during chemotherapy or resumed normal menses, FSH and estradiol levels remained unchanged.ConclusionAnti-Müllerian hormone and AFC are useful as markers of OVR decline in women exposed to chemotherapy. Follicle-stimulating hormone is only adequate in women who become amenorrheic.
authors.affiliation: Graduate Program in Medicine: Medical Sciences, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Ângela Marcon
authors.initials: ÂM
authors.lastname: D'Avila
authors.affiliation: Graduate Program in Medicine: Medical Sciences, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Edison
authors.initials: E
authors.lastname: Capp
authors.affiliation: Graduate Program in Medicine: Medical Sciences, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Helena von Eye
authors.initials: HVE
authors.lastname: Corleta
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy*; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006080:Ovarian Follicle; D065851:Ovarian Reserve
chemical_list: D018906:Antineoplastic Agents, Alkylating; D054304:Anti-Mullerian Hormone; D003520:Cyclophosphamide