TY - JOUR
T1 - Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding
AU - Nakano, Hirofumi
AU - Ashizawa, Masahiro
AU - Akahoshi, Yu
AU - Ugai, Tomotaka
AU - Wada, Hidenori
AU - Yamasaki, Ryoko
AU - Ishihara, Yuko
AU - Kawamura, Koji
AU - Sakamoto, Kana
AU - Sato, Miki
AU - Terasako-Saito, Kiriko
AU - Kimura, Shun ichi
AU - Kikuchi, Misato
AU - Nakasone, Hideki
AU - Kako, Shinichi
AU - Kanda, Junya
AU - Yamazaki, Rie
AU - Tanihara, Aki
AU - Nishida, Junji
AU - Kanda, Yoshinobu
N1 - Publisher Copyright:
© 2016, The Japanese Society of Hematology.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.
AB - Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.
KW - Anti-Müllerian hormone
KW - Fertility
KW - Hematopoietic stem cell transplantation
KW - Ovarian reserve
KW - Ovarian shielding
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U2 - 10.1007/s12185-016-1998-y
DO - 10.1007/s12185-016-1998-y
M3 - Article
C2 - 27084256
AN - SCOPUS:84963774951
VL - 104
SP - 110
EP - 116
JO - International Journal of Hematology
JF - International Journal of Hematology
SN - 0925-5710
IS - 1
ER -