A predictive model for chemotherapy-related diminished ovarian reserve in reproductive-age women

Age, cancer type, type of chemotherapy, and pre-chemotherapy serum AMH level can accurately predict diminished ovarian reserve caused by chemotherapy.

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VOLUME 115, ISSUE 2, P431-437

Authors:

Margaret M. Hopeman, M.D., Katherine E. Cameron, M.D., M.B.E., Maureen Prewitt, R.N., C.C.E., Kurt Barnhart, M.D., M.S.C.E., Jill P. Ginsberg, M.D., Mary D. Sammel, Sc.D., Clarisa R. Gracia, M.D., M.S.C.E.

Abstract:

Objective

To develop and internally validate a clinical predictive tool to assess the likelihood that a young cancer patient will experience diminished ovarian reserve (DOR) after chemotherapy.


Design

Prospective cohort study.


Setting

University hospitals.


Patient(s)

Postpubertal adolescent and young adult women with a new diagnosis of cancer requiring chemotherapy.


Intervention

None.


Main Outcome Measure(s)

Diminished ovarian reserve after completion of and recovery from chemotherapy, defined as serum antimüllerian hormone (AMH) <1 ng/mL at 8–24 months after completion of chemotherapy.


Result(s)

A multivariable logistic regression model which includes age, cancer type, exposure to an alkylating agent, and baseline AMH value accurately predicts the diagnosis of DOR after chemotherapy with an area under the receiver operating characteristic curve of 0.89.


Conclusion(s)

Pretreatment information on age, cancer type, use of an alkylating agent, and baseline AMH levels make up a clinically useful predictive tool to identify which women are most at risk for DOR caused by chemotherapy.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.