The overall negative influence of chemotherapy on ovarian reserve is well established. Since few years, AMH is used as a fertility marker, both in assisted reproductive technology and oncology. Surprisingly, if young patients are the most ones concerned with fertility questions, the specific impact of adjuvant chemotherapy for EBC in this population is unknown. In this context, we analysed AMH in patients ≤ 35 years presenting an EBC, before any treatment, at 1, 3 and 5 years after diagnosis.
This is a monocentric retrospective study. Patients aged ≤35 years treated for EBC between 2008 and 2014, with frozen heparined plasma samples before and after chemotherapy exposure and with a written consent for research use were included. All analysis were performed simultaneously with Elecsys® AMH assay (Roche Diagnostics). Statistics were performed using Mann-Whitney or Wilcoxon tests.
Fifty-four patients were included, 23 (43%) had a triple negative and 29 (54%) a hormonal positive receptors tumor. Median age at diagnosis was 31.5 years (range 22-35). Median AMH before treatment was 2.12 ng/mL (range 0.33-17.5) and dropped to 0.13 ng/mL (0.01-6.1, p
Despite a normal ovarian reserve before treatment, AMH decreases deeply 1 year after diagnosis, whatever the age of the patient. A slight recovery can be observed 3 years after diagnosis, without ranging the normal expected values for the age. Use of taxanes seems to increase gonadotoxicity.
Clinical trial identification
Legal entity responsible for the study
Centre Henri Becquerel
Centre Henri Becquerel, Department of Biopathology
All authors have declared no conflicts of interest.