Five-year study assessing the clinical utility of Anti-Müllerian Hormone (AMH) measurements in reproductive age women with cancer

Abstract Research question An important discussion point prior to chemotherapy is ovarian toxicity, a side effect that profoundly affects young women with cancer. Their quality of life after successful treatment, including the ability to conceive, is a major concern. We asked whether serum Anti - Mullerian hormone (AMH) measurements before chemotherapy for two most common malignancies are predictive of long-term changes in ovarian reserve? Design A prospective cohort study measured serum AMH in 66 young, female, lymphoma and breast cancer patients, before and at 1 year and 5 years after chemotherapy, compared with 124 healthy volunteers of the same age range (18-43). Contemporaneously, patients reported their menses and live births during 5-year follow-up. Results After adjustment for age, serum AMH was 1.4 times higher (95% CI, 1.1-1.9, p p p =0.37). Conclusions Reproductive age women with malignancy have lower serum AMH than healthy controls even before starting chemotherapy. Pre-chemotherapy AMH was significantly associated with long term ovarian function in women with breast cancer. AMH measurements at key time points could be utilised as a reproductive health advisory tool for young women with cancer. Our results highlight the unsuitability of return of menstruation as a clinical indicator of ovarian reserve post-chemotherapy.