科研之友
微信
新浪微博
Facebook
分享链接
摘要
We evaluated ovarian function by measuring the levels of anti-M邦llerian hormone (AMH), estradiol, and gonadotropins in 83 young women treated for cancer during childhood and adolescence, and classified according to post-treatment gonadal toxicity versus 38 healthy females. Results. The mean AMH values were lower in the entire cohort independently of the risk group as compared to the control, whereas FSH was elevated only in the high risk group. The lowest AMH values were noted in patients after bone marrow transplantation (BMT) and those treated for Hodgkin lymphoma (HL). Nineteen patients (22.9%) had elevated FSH. They all had low AMH values. Lowered AMH values (but with normal FSH and LH) were observed in 43 patients (51.8%). There was no effect of age at the time of treatment (before puberty, during or after puberty) on AMH levels. Conclusion. Our results show the utility of AMH measurement as a sensitive marker of a reduced ovarian reserve in young cancer survivors. Patients after BMT and patients treated for HL, independently of age at treatment (prepuberty or puberty), are at the highest risk of gonadal damage and early menopause. 1. Introduction The use of combined chemo- and radiotherapy for childhood cancer treatment has led to an increased survival rate and posed new challenges concerning health problems, organ damage, and quality of life after anticancer therapy. The function of different tissues and organs may be differently impaired by aggressive therapy. Gonads are particularly exposed to the deteriorating effects of certain chemotherapeutics and radiotherapy; on the other hand, when survivors reach adulthood, they wish to have their own biological children [1每3]. Fertility after anticancer therapy is a very important problem known by oncologists and endocrinologists as well as by cancer survivors themselves. In women, gonadotoxic therapy damages the primordial follicles in the ovaries, which can lead to premature menopause. Very aggressive therapy such as myeloablative therapy prior to bone marrow transplantation (BMT) or surgery/ovariectomy can lead to total sterility, whereas indirect irradiation of the ovaries and chemotherapy can result in a lowered ovarian reserve [4每6]. In the last years, the measurement of anti-M邦llerian hormone (AMH) has been used as an informative marker of the ovarian reserve. AMH is a product of granulosa cells of preantral and early antral follicles, capable of growing. In healthy women, AMH measurement is useful for the determination of the reproductive life span and the time of future menopause [7, 8]. The
