Evaluation of ovarian reserve before and after chemotherapy.


Journal

Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588

Informations de publication

Date de publication:
May 2021
Historique:
received: 16 08 2020
revised: 20 11 2020
accepted: 03 12 2020
pubmed: 12 12 2020
medline: 6 11 2021
entrez: 11 12 2020
Statut: ppublish

Résumé

Progress in oncology has improved patient survival. However, cancer chemotherapy can be gonadotoxic and affect their fertility. Recourse to fertility preservation before starting these treatments is therefore necessary in order to allow a better life quality after survival. The aim of this work was to study the impact of chemotherapy on ovarian reserve by AMH measurement. This is a descriptive and longitudinal study from 2015 to 2018 carried out at Aziza Othmana hospital ART center in Tunis on patient aged less than 41 years who were candidates for fertility preservation. Patients included had AMH measurement prior to cancer treatment. We called them back to follow up the AMH level after chemotherapy. The AMH assay was performed by electrochemilumiescence technique. At the end, only 66 patients met the inclusion criteria. The most frequent pathologies were Hodgkin's lymphoma and breast cancer. The mean age of patients was 26.7 ± 6.8. The most used chemotherapy protocols were BEACOPP, ABVD or the combination of both in lymphoma and FEC + TXT for breast cancer treatment. A significant difference between AMH before and after chemotherapy was found for BEACOPP and FEC + TXT protocols (p < 10 3). The patient's age was correlated with the AMH decrease after chemotherapy (r = 0.577, p < 10 3). Our results showed that the high risk gonadotoxicity protocols were BEACOPP for lymphoma treatment and FEC + TXT for breast cancer treatment. However, studies with a larger sample and more time extended monitoring are necessary for a better gonadotoxicity understanding of the cancer treatments available today.

Sections du résumé

BACKGROUND BACKGROUND
Progress in oncology has improved patient survival. However, cancer chemotherapy can be gonadotoxic and affect their fertility. Recourse to fertility preservation before starting these treatments is therefore necessary in order to allow a better life quality after survival. The aim of this work was to study the impact of chemotherapy on ovarian reserve by AMH measurement.
METHODS METHODS
This is a descriptive and longitudinal study from 2015 to 2018 carried out at Aziza Othmana hospital ART center in Tunis on patient aged less than 41 years who were candidates for fertility preservation. Patients included had AMH measurement prior to cancer treatment. We called them back to follow up the AMH level after chemotherapy. The AMH assay was performed by electrochemilumiescence technique. At the end, only 66 patients met the inclusion criteria.
RESULTS RESULTS
The most frequent pathologies were Hodgkin's lymphoma and breast cancer. The mean age of patients was 26.7 ± 6.8. The most used chemotherapy protocols were BEACOPP, ABVD or the combination of both in lymphoma and FEC + TXT for breast cancer treatment. A significant difference between AMH before and after chemotherapy was found for BEACOPP and FEC + TXT protocols (p < 10 3). The patient's age was correlated with the AMH decrease after chemotherapy (r = 0.577, p < 10 3).
CONCLUSION CONCLUSIONS
Our results showed that the high risk gonadotoxicity protocols were BEACOPP for lymphoma treatment and FEC + TXT for breast cancer treatment. However, studies with a larger sample and more time extended monitoring are necessary for a better gonadotoxicity understanding of the cancer treatments available today.

Identifiants

pubmed: 33307239
pii: S2468-7847(20)30411-6
doi: 10.1016/j.jogoh.2020.102035
pii:
doi:

Substances chimiques

Bleomycin 11056-06-7
Docetaxel 15H5577CQD
Procarbazine 35S93Y190K
Epirubicin 3Z8479ZZ5X
Vincristine 5J49Q6B70F
Vinblastine 5V9KLZ54CY
Etoposide 6PLQ3CP4P3
Dacarbazine 7GR28W0FJI
Doxorubicin 80168379AG
Anti-Mullerian Hormone 80497-65-0
Cyclophosphamide 8N3DW7272P
Fluorouracil U3P01618RT
Prednisone VB0R961HZT

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102035

Informations de copyright

Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Déclaration de conflit d'intérêts

Declarations of Competing Interest None.

Auteurs

Khadija Kacem Berjeb (KK)

University of Medicine of Tunis, Laboratory of Reproductive Biology and Cytogenetic Laboratory. Aziza Othmana Hospital, Tunis, Tunisia. Electronic address: Khadija.berjeb@yahoo.fr.

Linda Debbabi (L)

University of Medicine of Tunis, Laboratory of Reproductive Biology and Cytogenetic Laboratory. Aziza Othmana Hospital, Tunis, Tunisia.

Marouen Braham (M)

University of Medicine of Tunis, Gynecology and Obstetrics Department. Aziza Othmana Hospital, Tunis, Tunisia.

Zeineb Zemni (Z)

University of Medicine of Tunis, Gynecology and Obstetrics Department. Aziza Othmana Hospital, Tunis, Tunisia.

Sana Chtourou (S)

University of Medicine of Tunis, Laboratory of Reproductive Biology and Cytogenetic Laboratory. Aziza Othmana Hospital, Tunis, Tunisia.

Hela Hannachi (H)

University of Medicine of Tunis, Biochemistry and Microbiology Laboratory, Aziza Othmana Hospital, Tunis, Tunisia.

Manel Hamdoun (M)

University of Medicine of Tunis, Biochemistry and Microbiology Laboratory, Aziza Othmana Hospital, Tunis, Tunisia.

Mouna Ayadi (M)

University of Medicine of Tunis, Medical Oncology Department. Salah Azaiz Institute, Tunis, Tunisia.

Karima Kacem (K)

University of Medicine of Tunis, Hematology Department. Aziza Othmana Hospital, Tunis, Tunisia.

Fethi Zhioua (F)

University of Medicine of Tunis, Gynecology and Obstetrics Department. Aziza Othmana Hospital, Tunis, Tunisia.

Anis Fadhlaoui (A)

University of Medicine of Tunis, Gynecology and Obstetrics Department. Aziza Othmana Hospital, Tunis, Tunisia.

Olfa Bahri (O)

University of Medicine of Tunis, Biochemistry and Microbiology Laboratory, Aziza Othmana Hospital, Tunis, Tunisia.

Nozha Chakroun (N)

University of Medicine of Tunis, Laboratory of Reproductive Biology and Cytogenetic Laboratory. Aziza Othmana Hospital, Tunis, Tunisia.

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Classifications MeSH