Opportunities for ovarian reserve preservation in the treatment of oncological diseases

GYNECOLOGY ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 21-25
Author(s):  
Juliia E. Dobrokhotova ◽  
Kseniia V. Morozova
Keyword(s):  
Cancer Patients ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Modern Medicine ◽  
Reproductive Age ◽  
Hormonal Function ◽  
Literary Sources ◽  
Oncological Diseases ◽  
Anticancer Treatment ◽  
Function Preservation

This article presents the data of multi-year research on the problem of ovarian reserve preservation in cancer patients. The review includes 64 literary sources. The review provides the main methods for ovarian function preservation during the treatment of malignant diseases in patients of reproductive age. Given the increasing number of cancer patients in the group of patients of reproductive age, modern medicine is faced with the task not only to provide effective anticancer treatment, but also to try to preserve ovarian function in order to maintain hormonal levels and fertility. Unfortunately, most cancer treatment methods inhibit ovarian function. Thanks to modern approaches, there are medicinal methods for protecting against ovarian inhibition, which allows to maintain hormonal function and come back to solve reproductive problems after recovering from cancer.

Serum anti-Müllerian hormone levels in reproductive-age women with relapsing–remitting multiple sclerosis

2014 ◽  
Vol 21 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Jan Thöne ◽  
Susanne Kollar ◽  
Darryl Nousome ◽  
Gisa Ellrichmann ◽  
Ingo Kleiter ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Reproductive Age ◽  
Unexpected Finding ◽  
Healthy Controls ◽  
Relapsing Remitting ◽  
Disease Modifying Treatment ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Control Study

Background: Fertility might be reduced in women with multiple sclerosis (MS), although only few studies exist and the underlying reasons are not well understood. Similar to other autoimmune diseases, a decreased ovarian reserve may contribute to impaired fertility in women with MS. Anti-Müllerian hormone (AMH) is an established marker of the ovarian reserve and an objective indicator of ovarian function, which is independent of the hypothalamus-pituitary-gonadal axis function. Objective: The purpose of this study was to determine AMH levels in females with relapsing–remitting MS (RRMS) in combination with other reproduction and lifestyle factors. Methods: A total of 76 reproductive-age females with RRMS and 58 healthy controls were included in this case control study. An enzymatically amplified two-site immunoassay was used to measure serum AMH level. Results: Mean AMH level was significantly decreased in females with RRMS ( p<0.04), and a higher proportion of females with RRMS showed very low AMH values (<0.4 ng/ml) compared to healthy controls ( p<0.05). The majority of these women were currently without any disease modifying treatment. Conclusions: Our data contribute to our understanding of impaired fertility in women with MS. The unexpected finding that the majority of MS subjects with very low AMH levels were currently without medication requires further evaluation.

scholarly journals Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ting Ding ◽  
Tian Wang ◽  
Jinjin Zhang ◽  
Pengfei Cui ◽  
Zhe Chen ◽  
...  
Keyword(s):  
Linear Regression ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Linear Regression Analysis ◽  
Reproductive Age ◽  
Menstrual Status ◽  
Serum Hormone ◽  
Reproductive Endocrine ◽  
Severe Group ◽  
Reproductive Aged Women

Objective: This study was intended to investigate the relationship between COVID-19 disease and ovarian function in reproductive-aged women.Methods: Female COVID-19 patients of reproductive age were recruited between January 28 and March 8, 2020 from Tongji Hospital in Wuhan. Their baseline and clinical characteristics, as well as menstrual conditions, were recorded. Differentials in ovarian reserve markers and sex hormones (including anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], the ratio of FSH to luteinizing hormone [LH], estradiol [E2], progesterone [P], testosterone [T], and prolactin [PRL] were compared to those of healthy women who were randomly selected and individually matched for age, region, and menstrual status. Uni- and multi-variable hierarchical linear regression analyses were performed to identify risk factors associated with ovarian function in COVID-19 women.Results: Seventy eight patients agreed to be tested for serum hormone, of whom 17 (21.79%) were diagnosed as the severe group and 39 (50%) were in the basal level group. Menstrual status (P = 0.55), menstrual volumes (P = 0.066), phase of menstrual cycle (P = 0.58), and dysmenorrhea history (P = 0.12) were similar without significant differences between non-severe and severe COVID-19 women. Significant lower serum AMH level/proportion (0.19/0.28 vs. 1.12 ng/ml, P = 0.003/0.027; AMH ≤ 1.1 ng/ml: 75/70.4 vs. 49.7%, P = 0.009/0.004), higher serum T (0.38/0.39 vs. 0.22 ng/ml, P &lt; 0.001/0.001) and PRL (25.43/24.10 vs. 12.12 ng/ml, P &lt; 0.001/0.001) levels were observed in basal level and the all-COVID-19 group compared with healthy age-matched control. When adjusted for age, menstrual status and parity variations in multivariate hierarchical linear regression analysis, COVID-19 disease was significantly associated with serum AMH (β = −0.191; 95% CI: −1.177–0.327; P = 0.001), T (β = 0.411; 95% CI: 11.154–22.709; P &lt; 0.001), and PRL (β = 0.497; 95% CI: 10.787–20.266; P &lt; 0.001), suggesting an independent risk factor for ovarian function, which accounted for 3.2% of the decline in AMH, 14.3% of the increase in T, and 20.7% of the increase in PRL.Conclusion: Ovarian injury, including declined ovarian reserve and reproductive endocrine disorder, can be observed in women with COVID-19. More attention should be paid to their ovarian function under this pandemic, especially regarding reproductive-aged women.Clinical Trial Number: ChiCTR2000030015.

scholarly journals Urinary Bisphenol A Concentrations and Parameters of Ovarian Reserve among Women from A Fertility Clinic

2021 ◽  
Vol 18 (15) ◽  
pp. 8041
Author(s):  
Ewelina Czubacka ◽  
Bartosz Wielgomas ◽  
Anna Klimowska ◽  
Michał Radwan ◽  
Paweł Radwan ◽  
...  
Keyword(s):  
Bisphenol A ◽  
Ovarian Reserve ◽  
Animal Studies ◽  
Ovarian Function ◽  
Ion Trap ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Fertilization Rate ◽  
Reproductive Age ◽  
Study Participants

Background: Human exposure to environmentally widespread endocrine disruptors, especially bisphenol A (BPA), has been suggested to affect reproductive health. Animal studies indicate that BPA may play a role in the process of reproduction and impact on maturing oocytes, meiotic cell division or fertilization rate. Nevertheless, data regarding the effects of exposure to BPA on women’s ovarian function are still limited. Therefore, the aim of the current study is to assess the effects of environmental exposure to BPA on ovarian reserve. Methods: The study participants consisted of 511 women in reproductive age (25–39 years) who attended an infertility clinic for diagnosis, due to the couples’ infertility. BPA urinary concentrations were assessed by the validated gas chromatography ion-trap mass spectrometry method. The ovarian reserve was assessed using ovarian reserve parameters: Hormones concentrations: E2 (estradiol), FSH (follicle stimulating hormone), AMH (anti-Müllerian hormone), and AFC (antral follicle count). Results: In the present study, the negative association between BPA urinary concentrations and AMH (p = 0.02) and AFC (p = 0.03) levels was found. Exposure to BPA was not related to other examined parameters of ovarian reserve (FSH, E2). Conclusions: Our results suggest that BPA exposure may affect women ovarian reserve parameters and reduce ovarian reserve. As this is one of the first studies of its kind, the findings need confirmation in a further investigation.

scholarly journals Anti-Müllerian hormone: determination of ovarian reserve in early breast cancer patients

2013 ◽  
Vol 21 (1) ◽  
pp. R51-R65 ◽  
Author(s):  
Claudia Bozza ◽  
Fabio Puglisi ◽  
Matteo Lambertini ◽  
Etin-Osa Osa ◽  
Massimo Manno ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Women ◽  
Ovarian Reserve ◽  
Menopausal Status ◽  
Poor Response ◽  
Reproductive Age ◽  
Endocrine Treatment ◽  
Breast Cancer Patients ◽  
Potential Marker

Breast cancer is the most common invasive cancer in women of reproductive age. In young women, chemotherapy may induce amenorrhea: it is still uncertain how to assess menopausal status in these patients despite the importance of its definition for choosing appropriate endocrine treatment. In the development of sensitive biomarkers for fertility and ovarian reserve, anti-Müllerian hormone (AMH) is considered a promising marker of ovarian reserve. The clearest data regarding a clinical use of AMH are related to the measurement of the ovarian pool in women who undergo IVF: the available data, also in breast cancer patients, seem to suggest that AMH measurement, before gonadotropin administration, can be a useful marker for the prediction of women at risk for poor-response or no response to ovarian stimulation. The utility of AMH as a potential marker of chemotherapy-induced ovarian follicular depletion and an early plasma marker of chemotherapy-induced gonadal damage has been evaluated both in young women after treatment for cancer in childhood and in young survivors of hematological malignancies and solid tumors. Several studies have demonstrated a potential utility of AMH, inhibin, or follicle-stimulating factor as biomarkers predicting infertility risk in breast cancer patients, but the studies conducted so far are not conclusive. Further studies are needed in order to define the regimen-specific action of chemotherapy on AMH levels, the percentage of post-treatment recovery of plasma levels of the hormone, and the relationship between menopausal status and AMH.

scholarly journals Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Felipe A. Morales-Martínez ◽  
Luis H. Sordia-Hernández ◽  
Martha Merino Ruiz ◽  
Selene Garcia-Luna ◽  
Otto H. Valdés-Martínez ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Function ◽  
Thyroid Autoimmunity ◽  
Antral Follicle ◽  
Serum Levels ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Autoimmune Hypothyroidism ◽  
Thyroid Hormone Concentration ◽  
The Impact

Abstract Background The ovarian function and therefore the ovarian reserve may be compromised by the pathogenesis of autoimmune diseases of which, Hashimoto’s thyroiditis (HT) is the most common in women of reproductive age. Furthermore, a prolonged reduction in thyroid hormone concentration results in a broad spectrum of reproductive alteration. Previous reports in the literature have been controversial regarding the impact of hypothyroidism and alterations in the ovarian reserve. Thus, this prospective and comparative study aimed to evaluate the association of hypothyroidism with low ovarian reserve. Materials and Methods A subset of 27 patients with primary autoimmune hypothyroidism were compared to healthy women. The ovarian reserve was assessed through the anti-Mullerian hormone (AMH) and the antral follicle count (AFC). Results Overall, the two groups did not display significant differences in length of their menstrual cycles neither in the AMH serum levels nor the AFC. Conclusions No significant alteration was found in the ovarian reserve of women with HT.

Anti-Müllerian hormone (AMH) as a marker of ovarian reserve and premature ovarian insufficiency (POI) in children and women with cancer: A systematic review.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24057-e24057
Author(s):  
David A. Cameron ◽  
Richard Anderson ◽  
Florian Clatot ◽  
Isabelle Demeestere ◽  
Matteo Lambertini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Ovarian Reserve ◽  
Post Treatment ◽  
Cancer Type ◽  
Partial Recovery ◽  
Pediatric Cancer Patients ◽  
Before And After ◽  
Anticancer Treatment ◽  
Pre Treatment

e24057 Background: Female patients undergoing anticancer treatment are at elevated risk of ovarian damage including development of POI. AMH is a key serum biomarker of ovarian reserve. However, its role to identify risk of POI in cancer patients prior to and after treatment is less well understood. Methods: A systematic literature search for AMH in women with cancer was conducted up to 30 August 2020, with formal bias assessment. We aimed at evaluating AMH as a biomarker of ovarian reserve and POI before and after anticancer treatment. Exploratory subgroups were based on age, cancer type and length of follow-up. Results: : Eighty publications (including 7,708 patients) were included in this analysis. All papers reporting AMH before and after treatment reported a large reduction in AMH following treatment, in both adult and paediatric populations. Effect sizes varied depending on the treatment and diagnosis, but ranged from 42% to below the limit of detection, and many reported declines of ≥90%. A majority (25/34, 74%) of studies also reported at least partial recovery of AMH at follow-up. Pre-treatment AMH correlated with post-treatment levels in all studies and younger patient age with higher post-treatment AMH in 21/29 (72%) studies. In 18/32 (58%) publications, oligo/amenorrhea correlated with lower post-treatment AMH. No studies reported correlations between post-treatment AMH and pregnancy, although pregnancy was reported in some patients with low or undetectable AMH. 70% of publications found that within-study variations in treatment (estimated by chemotherapy or radiotherapy type, dosage, duration and/or number of cycles) correlated with AMH reductions and degree of recovery, indicating its potential value as a marker of gonadotoxicity. In women with breast cancer, recovery of AMH was reported in some patients in 10/18 publications; however, AMH levels showed no recovery in many patients receiving alkylating agents or cyclophosphamide-based chemotherapies. In lymphoma, patients receiving ABVD-based regimens had at least partial post-treatment recovery of AMH at follow-up compared with those receiving cyclophosphamide-containing regimens. 16/20 (80%) publications in pediatric cancer patients showed significant reductions in AMH compared with pre-treatment levels or controls. The diagnostic value of post-treatment AMH for POI was supported in 5/5 (100%) studies. AMH levels measured 1–2 years after treatment appeared to be equally reliable at indicating longer-term menstrual outcomes as studies with longer followup. Conclusions: AMH levels were strongly impacted by anticancer treatment, with recovery in some women determined by treatment regimen, age, and pretreatment AMH level. There was evidence for its role in diagnosis of POI, nut further studies are required to clarify its value to assist in patient management.

scholarly journals The Use of Acupuncture as an Alternative Treatment Method for Ovarian Dysfunction: A Narrative Review

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Xu J ◽  
Fan Y ◽  
Geng J ◽  
Zhang Y ◽  
Xia T
Keyword(s):  
Assisted Reproduction ◽  
Ovarian Function ◽  
Elderly Women ◽  
Hot Spot ◽  
Alternative Therapy ◽  
Treatment Method ◽  
Modern Medicine ◽  
Reproductive Age ◽  
Future Application ◽  
Complementary And Alternative Therapy

It is well known that diminished ovarian reserve is one of the main causes of infertility in older women. Also, due to the delayed reproductive age of women, there is a gradual increase in the number of elderly women using assisted reproduction techniques to assist pregnancy. However, due to the decrease in ovarian function, the sensitivity of ovaries to gonadotropin (Gn) is reduced and follicles fail to develop and mature to ovulation, which is one of the important reasons for cancelling cycles during the application of assisted reproduction for ovulation. Therefore, improving ovarian function is an important factor in improving pregnancy rates in advanced women during assisted conception. Modern medicine has no clear drugs to restore ovarian function in women, while acupuncture, as an effective and simple complementary and alternative therapy, has gradually become a hot spot for application in patients with reduced ovarian function in recent years. Therefore, this paper aims to investigate the mechanism, clinical efficacy and future application prospects of acupuncture in improving ovarian function in women.

EVALUATION OF OVARIAN RESERVE IN FEMALE INFERTILITY

2021 ◽  
pp. 45-45
Author(s):  
Renuka Keshri ◽  
Chandni Singh
Keyword(s):  
Ovarian Reserve ◽  
Function Method ◽  
Ovarian Function ◽  
Age Groups ◽  
Female Infertility ◽  
Reproductive Age ◽  
Age Group ◽  
Level Variation ◽  
Reliable Test ◽  
Reproductive Age Group

INTRODUCTION: Infertility is not uncommon amongst females in reproductive age group. Different hormones like antimullerian hormone (AmH) and FSH levels are expression of ovarian function. The changes in AmH level precedes FSH level variation in detecting decline in ovarian function. METHOD : In our study, we have assessed AmH level in different age groups of females suffering from infertility to evaluate ovarian reserve in them. RESULT : Our study shows that with advancing age ovarian function declines as evidenced by decrease in AmH level causing female infertility. CONCLUSION : AmH level estimation is an important tool to assess ovarian reserve in female infertility. It is a simple, less expensive and reliable test before further investigations to nd out other etiologies of infertility

scholarly journals Burning Questions in the Oncofertility Counseling of Young Breast Cancer Patients

2020 ◽  
Vol 14 ◽  
pp. 117822342095417 ◽  
Author(s):  
Luca Arecco ◽  
Marta Perachino ◽  
Alessandra Damassi ◽  
Maria Maddalena Latocca ◽  
Davide Soldato ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Young Women ◽  
Reproductive Age ◽  
Prior History ◽  
Breast Cancer Patients ◽  
History Of ◽  
Anticancer Treatment ◽  
Young Breast Cancer

The improved prognosis of breast cancer patients makes survivorship issues an area of crucial importance. In this regard, an increased attention is needed toward the development of potential anticancer treatment-related long-term side-effects, including gonadal failure and infertility in young women. Therefore, fertility preservation and family planning are crucial issues to be addressed in all young women of reproductive age with newly diagnosed cancer. Despite a growing availability of data on the efficacy and safety of fertility preservation options and the fact that conceiving after prior history of breast cancer has become more accepted over time, there are still several gray zones in this field so that many physicians remain uncomfortable to deal with these topics. The purpose of this review is to answer some of the most controversial questions frequently asked by patients during their oncofertility counseling, in order to provide a detailed and up-to-date overview on the evidence available in this field to physicians involved in the care of young women with breast cancer.

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