Impact of cancer therapies on ovarian reserve

Measures of ovarian reserve are impaired among cancer survivors compared with unexposed females of similar age. The degree of impairment is dependent on the toxicity of the previous treatment.


Clarisa R. Gracia, M.D., M.S.C.E., Mary D. Sammel, Sc.D., Ellen Freeman, Ph.D., Maureen Prewitt, R.N., Claire Carlson, R.N., Anushree Ray, Ashley Vance, Jill P. Ginsberg, M.D.

Volume 97, Issue 1 , Pages 134-140.e1



To determine whether measures of ovarian reserve differ between females exposed to cancer therapies in a dose-dependent manner as compared with healthy controls of similar age and late reproductive age.


Cross-sectional analysis of data from a prospective cohort study.


University medical center.


Seventy-one cancer survivors aged 15–39 years; 67 healthy, similarly aged unexposed subjects; and 69 regularly menstruating women of late reproductive age (40–52 years).



Main Outcome Measure(s):

Early follicular-phase hormones (FSH, E2, inhibin B, antimüllerian hormone [AMH]) and ovarian ultrasound measurements (ovarian volume and antral follicle counts [AFC]) were compared using multivariable linear regression.


In adjusted models, FSH, AMH, and AFC differed between exposed vs. unexposed subjects (FSH 11.12 mIU/mL vs. 7.25 mIU/mL; AMH 0.81 ng/mL vs. 2.85 ng/mL; AFC 14.55 vs. 27.20). In participants with an FSH


Measures of ovarian reserve are impaired in a dose-dependent manner among cancer survivors compared with unexposed females of similar age. Reproductive hormone levels in menstruating survivors exposed to high-dose therapy are similar to those in late-reproductive-age women. The predictive value of measures for pregnancy and menopause must be studied. identifier:


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