TY - JOUR
T1 - Differential Rates of Change in Measures of Ovarian Reserve in Young Cancer Survivors across the Reproductive Lifespan
AU - Cameron, Katherine
AU - Sammel, Mary D.
AU - Prewitt, Maureen
AU - Gracia, Clarisa
N1 - Funding Information:
Financial Support: Support for this work was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grants K01 L:1-CA-133839-03 to C.G. and 1R01HD062797 to C.G. and M.D.S.).
Publisher Copyright:
© 2019 Endocrine Society.
PY - 2019
Y1 - 2019
N2 - Context: Recent studies have examined level and rate of change of anti-Müllerian hormone (AMH) for predicting time to menopause. Limited prospective, longitudinal data exists evaluating measures of ovarian reserve (MOR) in cancer survivors. Purpose: Determine the rate of change of MOR in survivors (15 to 39 years) compared with similar-aged controls and compared with late reproductive-aged controls (40 to 50 years). Design: Prospective cohort. Setting: Quaternary university hospital. Participants: Survivors at least 1 year from therapy completion, similar-aged controls, and late reproductive-aged controls. Interventions: Annual visits with early follicular-phase hormone analysis and ultrasound. Main Outcome Measure: Changes in AMH and antral follicle count (AFC) were modeled using random effects linear regression. Results: Cancer survivors (170) and 135 similar-aged controls had annual visits for an average of 38 months; 71 late reproductive-aged controls were followed for an average of 24 months. In models adjusted for body mass index, time since cancer therapy (for survivors), and exogenous hormone use, the geometric mean AMH and AFC levels were lower in the survivors than similar-aged controls at all ages. After age 24.5 AMH and AFC declined in both groups at rates that were similar (P = 0.78 for AMH, P = 0.37 for AFC). Late reproductive-aged controls declined at a much more precipitous rate of 30% per year for AMH and 16% per year for AFC (P < 0.01 compared with survivors). Conclusions: Although survivors had lower levels of AMH and AFC at the time of enrollment, the rate of change of AMH and AFC is not significantly different than similar-aged controls.
AB - Context: Recent studies have examined level and rate of change of anti-Müllerian hormone (AMH) for predicting time to menopause. Limited prospective, longitudinal data exists evaluating measures of ovarian reserve (MOR) in cancer survivors. Purpose: Determine the rate of change of MOR in survivors (15 to 39 years) compared with similar-aged controls and compared with late reproductive-aged controls (40 to 50 years). Design: Prospective cohort. Setting: Quaternary university hospital. Participants: Survivors at least 1 year from therapy completion, similar-aged controls, and late reproductive-aged controls. Interventions: Annual visits with early follicular-phase hormone analysis and ultrasound. Main Outcome Measure: Changes in AMH and antral follicle count (AFC) were modeled using random effects linear regression. Results: Cancer survivors (170) and 135 similar-aged controls had annual visits for an average of 38 months; 71 late reproductive-aged controls were followed for an average of 24 months. In models adjusted for body mass index, time since cancer therapy (for survivors), and exogenous hormone use, the geometric mean AMH and AFC levels were lower in the survivors than similar-aged controls at all ages. After age 24.5 AMH and AFC declined in both groups at rates that were similar (P = 0.78 for AMH, P = 0.37 for AFC). Late reproductive-aged controls declined at a much more precipitous rate of 30% per year for AMH and 16% per year for AFC (P < 0.01 compared with survivors). Conclusions: Although survivors had lower levels of AMH and AFC at the time of enrollment, the rate of change of AMH and AFC is not significantly different than similar-aged controls.
UR - http://www.scopus.com/inward/record.url?scp=85068537884&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068537884&partnerID=8YFLogxK
U2 - 10.1210/jc.2018-02257
DO - 10.1210/jc.2018-02257
M3 - Article
C2 - 30566616
AN - SCOPUS:85068537884
SN - 0021-972X
VL - 104
SP - 1813
EP - 1822
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 5
M1 - jcem-201802257
ER -