Abstract
The Use of AMH to Assess Ovarian Toxicity in Adolescents and Young Adults After Cancer Treatment.
Highlights
The dynamic nature of ovarian function means that there are large variations in conventional markers of ovarian activity, notably estradiol and follicle stimulating hormone. These largely reflect the latest stages of follicle growth in relation to ovulation, and it has really been the advent of the measurement of anti-Müllerian hormone (AMH) that has given us the opportunity to explore the activity of the ovary in terms of its smaller follicles (4)
The question of the longer-term function of the chemotherapy-exposed ovary remains very uncertain, and it is this that Su and colleagues have investigated in a paper in the current edition of the Journal of Clinical Endocrinology and Metabolism (7)
All other patients were stratified into the moderate gonadotoxicity group, which included patients exposed to alkylating agent chemotherapy below cyclophosphamide equivalent dose (CED) 7 grams/m2 and any other chemotherapy, rather surprisingly included patients who had a hysterectomy or unilateral oophorectomy
Summary
The field of pediatric oncology has assimilated the overlapping concepts of survivorship and late effects, recognizing that a key objective of treatment is to increase the number of young people surviving while minimizing long-term disadvantage and ill health (1). Measurement of AMH has become routine in assisted reproduction as a predictor of the ovarian response to stimulation, but its potential role in diagnosing—or predicting—menopause in healthy women and premature ovarian insufficiency (POI) in patients diagnosed and treated for cancer have been recognized.
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