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The effects of chemotherapy and long-term gonadotrophin suppression on the ovarian reserve in premenopausal women with breast cancer

Anderson, R.A. ; Themmen, A.P.N. ; -Qahtani, A.Al ; Groome, N.P. ; Cameron, D.A.

Human reproduction (Oxford), 2006-10, Vol.21 (10), p.2583-2592 [Periódico revisado por pares]

England: Oxford University Press

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Título:
The effects of chemotherapy and long-term gonadotrophin suppression on the ovarian reserve in premenopausal women with breast cancer
Autor: Anderson, R.A. ; Themmen, A.P.N. ; -Qahtani, A.Al ; Groome, N.P. ; Cameron, D.A.
Assuntos: Adult ; anti-Müllerian hormone ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Breast Neoplasms - blood ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - drug therapy ; Breast Neoplasms - surgery ; chemotherapy ; Female ; Follicle Stimulating Hormone - blood ; Follicular Phase - drug effects ; Follicular Phase - physiology ; gonadotrophin ; Gonadotropins - antagonists & inhibitors ; Gynecology. Andrology. Obstetrics ; Humans ; Luteinizing Hormone - blood ; Medical sciences ; Menstrual Cycle ; ovary ; Ovary - diagnostic imaging ; Ovary - drug effects ; Ovary - physiology ; Ovary - physiopathology ; Premenopause ; Ultrasonography
É parte de: Human reproduction (Oxford), 2006-10, Vol.21 (10), p.2583-2592
Notas: ark:/67375/HXZ-XPLC0VLF-G
istex:341FCAB3493B4B6D44840546A670AF278745B20C
ArticleID:del201
Descrição: BACKGROUND Reproductive function following cancer treatment is of increasing importance with improving survival rates. We therefore assessed the markers of the ovarian reserve in premenopausal women, to investigate and compare the effects of chemotherapy and long-term gonadotrophin withdrawal on ovarian function. METHODS Fifty premenopausal (age range 28–52 years) women with early breast cancer were recruited. Serum hormone and ovarian ultrasound measurements were taken before treatment and at intervals up to 1 year during chemotherapy or gonadotrophin suppressive therapy. RESULTS Pretreatment samples indicated a fall in anti-Müllerian hormone (AMH) concentration with age before changes in other hormone concentrations. AMH concentration showed a rapid and marked fall during chemotherapy, with undetectable concentrations in many women (P < 0.0001). Inhibin B concentration showed a lesser fall (P < 0.0001), whereas estradiol (E2) concentrations were maintained. Both antral follicle count (AFC) and ovarian volume fell (P< 0.0001 and P< 0.05 respectively). Regimens containing taxanes in addition to cyclophosphamide showed increased gonadotoxicity. Gonadotrophin suppression resulted in expected falls in E2 (P< 0.05) and inhibin B (P< 0.001) levels, but also resulted in a delayed fall in AMH level after 6 months (P< 0.0001). CONCLUSIONS These data confirm the value of AMH concentration as an early indicator of ovarian ageing including assessment of chemotherapy-induced ovarian follicle loss. FSH and AMH concentration measurements may be useful for the comparison of ovarian toxicity of different chemotherapy regimens.
Editor: England: Oxford University Press
Idioma: Inglês

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The effects of chemotherapy and long-term gonadotrophin suppression on the ovarian reserve in premenopausal women with breast cancer

Anderson, R.A. ; Themmen, A.P.N. ; -Qahtani, A.Al ; Groome, N.P. ; Cameron, D.A.

England: Oxford University Press

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