Journal Article
. 2009 Apr; 94(1):156-66.
doi: 10.1016/j.fertnstert.2009.02.043.

Dynamics and mechanisms of chemotherapy-induced ovarian follicular depletion in women of fertile age

Mikkel Rosendahl 1 Claus Yding Andersen  Nina la Cour Freiesleben  Anders Juul  Kristine Løssl  Anders Nyboe Andersen  
  • PMID: 19342041
  •     31 citations


Objective: To study ovarian follicular dynamics during chemotherapy to understand the mechanisms behind chemotherapy-induced ovarian follicular depletion and to evaluate whether pretreatment levels of ovarian reserve markers were predictive of the posttreatment levels.

Design: Prospective clinical study.

Setting: University hospital fertility center.

Patient(S): Seventeen women (median age 30 years; range 19-35 years) undergoing chemotherapy.

Intervention(S): Patients were seen before, frequently during, and after chemotherapy, until 1 year after the end of treatment. Antral follicle count and levels of FSH, LH, E(2), anti-Müllerian hormone (AMH), and inhibin A and B were monitored at each visit.

Main Outcome Measure(S): The dynamics of the ovarian reserve markers during chemotherapy and factors predictive of posttreatment ovarian function.

Result(S): Anti-Müllerian hormone level (mean +/- 2 SEM) dropped from 2.7 +/- 1.0 to 1.1 +/- 0.6 and to 0.4 +/- 0.4 ng/mL immediately after one and two series of chemotherapy, respectively. Inhibin B and antral follicle count decreased after three series whereas FSH reached menopausal levels after four series. High pretreatment AMH levels predicted higher posttreatment AMH levels.

Conclusion(S): Anti-Müllerian hormone and inhibin B levels immediately declined in response to chemotherapy, and the follicular target of chemotherapy appeared to be growing follicles. High pretreatment AMH levels were predictive of a higher posttreatment AMH level.

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