Background
Chemotherapy and ovarian follicles
AMH and follicles
Methods
Results and discussion
AMH pre/post chemotherapy
Study | Cancer | Number of patients | Conclusion |
---|---|---|---|
Lutchman-Singh, 2007 [46] | Breast | 22 | -AMH post-CT < AMH pre-CT |
-AMH pre-CT = AMH in age-matched controls | |||
Lie Fong, 2008 [49] | Haematological | 25 | -AMH post-CT < AMH pre-CT |
-AMH pre-CT < AMH in older controls | |||
Aslam, 2011 [47] | All types | 8 | -AMH post-CT < AMH pre-CT |
-AMH post-CT < AMH in age-matched controls with the same follow-up | |||
Lawrenz, 2012 [48] | Lymphoma | 38 | -AMH post-CT < AMH pre-CT |
-AMH pre-CT < AMH in age-matched controls | |||
-Number of retrieved oocyte for cryopreservervation in lymphoma < retrieved oocytes in women with breast cancer |
AMH prior to, during and after chemotherapy
Study | Cancer | Treatment | Age (range) | Times of AMH measurement | Number of patients | Conclusions about AMH follow up |
---|---|---|---|---|---|---|
Early stage breast cancer | 7 protocols all including alkylating agents | 41 (28–52) | Before CT, every 3 months during CT | 56 | -Significant fall of AMH levels 3 months after the start of CT. | |
-Undetectable values of AMH in most patients at the end of CT. | ||||||
-Different degrees of gonadotoxicity according to protocols. | ||||||
Anders, 2008 [27] | Early stage breast cancer | Anthracycline, cyclophosphamide and taxane | 40 (21–51) | Before CT, 3 to 6 weeks post CT, 6 months and year post CT | 38 | -Undetectable values of AMH in most patients at the end of CT and one year post-CT. |
-Pre-CT AMH levels lower among women who became amenorrheic compared to those who resumed menses. | ||||||
Decanter, 2010 [24] | Lymphoma | Alkylating or non Alkylating regimens | 24 (18–32) | Before CT, 15 days after first cycle, 15 days before last cycle, every 3 months after CT until 1 year | 30 (17 non alkylating protocol, 13 alkylating protocol) | No difference between protocols regarding the depletion phase: |
-Acute fall of AMH as soon as 15 days after the start of CT. | ||||||
-Undetectable values of AMH at the end of CT in both protocols. | ||||||
Different recovery phases according to protocol: | ||||||
-Very low or undetectable AMH levels in the alkylating group 1 year post-CT. | ||||||
-Return to pre-treatment values of AMH as soon as the 6th month of follow-up in the non-alkylating group. | ||||||
Rosendahl, 2010 [53] | Lymphoma, Breast cancer, Ewing sarcoma | 7 different protocols | 30 (19–35) | Before CT, one week after each CT or every 2 weeks until 16 weeks of treatment, once a month until one year after first CT | 17 (13 alkylating protocol, 4 non alkylating protocol) | -Acute fall of AMH levels as soon as one week after the first cycle of CT. |
-Undetectable values of AMH in most patients at the end of CT. | ||||||
-Significantly lower AMH one year after the end of CT in case of alkytlating protocols than in case of non alkylating ones. | ||||||
Yu, 2010 [29] | Breast cancer | 3 different protocols all including alkylating agents | 37 (27–40) | Before CT, 6, 12, 36 and 52 weeks after first CT | 26 | -Significant fall of AMH levels 6 weeks after the start of CT. |
-Undetectable values of AMH in most patients at the end of CT. | ||||||
-Undetectable AMH levels in all patient but one 52 weeks after first CT. | ||||||
Anderson, 2011 [25] | Early stage breast cancer | 7 protocols all including alkylating agents | 41 (28,6-52,7) | Before CT, 2,3,4 and 5 years post CT | 42 | -Lower serum AMH levels, 2–5 years after CT, than pretreatment ones. |
-Undetectable AMH in most women, 2–5 years post-CT. | ||||||
-Pretreatment AMH level is strongly predictive of long term ovarian function after CT. | ||||||
Dillon, 2013 [52] | Different types of cancer | Different protocols | 26,1 (15 – 35,9) | Before CT, Every 3 month during and after treatment | 46 (33 alkylating protocol) | Difference between protocols regarding the depletion phase: |
-Significant fall of AMH levels 3 months after initiation of CT in alkylating and non-alkylating groups | ||||||
-Lower AMH at the end of treatment with alkylating agents compared with unexposed participants | ||||||
Different recovery phases according to protocol and to pretreatment AMH level: | ||||||
-Rate of recovery of AMH 9 months after CT higher in non alkylating protocol than in alkylating protocol | ||||||
-Rate of recovery of AMH 9 months after CT higher when pre-treatment AMH was >2 ng/ml than when it was ≤ 2 ng/m | ||||||
Anderson, 2013 [26] | Early stage breast cancer | 8 protocols, 7 including alkylating agents | 42,6 (23,3–52,5) | Before CT, after 1 or 2 cycles of CT, 1 and 2 years post CT | 59 | -Significant fall of AMH after 1 cycle of CT. |
-Undetectable values of AMH in most patients after 2 or more cycles of CT and at 1 year post CT. | ||||||
-Pretreatment AMH level is strongly predictive of post CT ovarian function (menses) at 1 and 2 years post CT. | ||||||
Henry, 2013 [51] | Breast cancer | 5 protocols all including alkylating agents except for 1 patient | 41 (25–50) | Before CT, 1 month post CT, 1 year post CT. | 27 | -Undetectable values of AMH in all patients 1 month post CT. |
-Undetectable AMH levels in most women 1 year post CT. |
Study | Cancer | Treatment | Age (range) | Times of AMH measurement | Number of patients | Conclusions about AMH follow up |
---|---|---|---|---|---|---|
Broughman, 2012 [54] | Different type of cancer | Different protocols (low/ medium/high gonadotoxic protocols) | 4,4 (0,3-15) | Before CT, after each CT course, between 2 and 12 months post CT, >12 months post CT | 22 (9 high gonadotoxic protocol, 13 medium or low gonadotoxic protocol) | No difference between protocols regarding the depletion phase: |
-Significant fall of AMH levels from the third cycle of CT in all protocols. | ||||||
-Undetectable values of AMH in most patients at the end of CT. | ||||||
Different recovery phases according to protocol: | ||||||
-Very low or undetectable AMH levels in the high gonadotoxic group more than 12 months post CT. | ||||||
-Return to pre-treatment AMH values as soon as the 6th month of follow-up in the medium/low group risk. | ||||||
Mörse, 2013 [55] | Different type of cancer | Different protocols | 9,5 (4,5-16,5) | Before CT, Every 3 month during and after CT | 34 (27 alkylating protocol) | No difference between protocols regarding the depletion phase: |
-Significant fall of AMH levels 3 months after initiation of CT. | ||||||
Different recovery phases according to protocol: | ||||||
-Very low or undetectable AMH levels in the group with irradiation below the diaphragm and/or stem cell transplantation 18 month post follow-up. | ||||||
-Return to pre-treatment or higher AMH values as soon as the 15th month of follow-up in acute lymphatic leukemia group. |