The impact of cancer therapy on the reproductive potential of patients is increasingly recognized because survival rates of patients have clearly improved in recent years. The study stressed the use of AMH may allow better prediction of chemotherapy-related risk to further fertility.
Materials and methods
A narrative review was performed within articles published at PubMed, Elsevier, SID and original text books to reach the aim.
AMH is a dimeric glycoprotein, a member of the transforming growth factor (TGF)-b super-family AMH is produced by the granulosa cells in the preantral and antral follicles. AMH is the most sensitive hormonal parameter in changes in ovarian reserve when compared with FSH of inhibin B. Anderson et al. explored forty-two women received chemotherapy for breast cancer, continuing menses 4–5 years after diagnosis closely reflected ovarian activity as assessed by a range of serum markers, including estradiol, inhibin B, FSH, and AMH. Pretreatment serum AMH, FSH, AFC, and age predicated late ovarian activity by univariate analysis. However, only AMH was predictive in a multivariate logistic regression; 0.71 ng/ml gave a peak likelihood ratio of 7.0 with 54% sensitivity and 92% specificity. In conclusion, measurement of AMH at cancer diagnosis predicts long-term ovarian function after chemotherapy. Lie Fong et al. Assessment of ovarian reserve in adult childhood cancer survivors using anti-mullerian hormone was studied in a total cohort of 185 survivors compared with 42 control subjects. The median follow-up time was 18.1 years. However, AMH levels were lower than the 10th percentile of normal values in 27% of our survivors. The relationship between serum AMH and the number of small growing and indeed primordial follicles has made it a prime potential tool for the investigation of gonadotoxicity of cancer therapy and loss of the ovarian reserve from ovarian surgery.
AMH can be used to identify subgroups of childhood cancer survivors at risk for decreased fertility or premature ovarian failure.