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Objective <p>The study examined the impact of various chemotherapy regimens on the ovarian reserve of women in reproductive age group. The potential demographic, clinical, and regime-related parameters factors modulating that effect were also studied.</p> Methods <p>This prospective cohort study enrolled women planned for chemotherapy for various malignancies, between the age of 18 and 45&#xa0;years. Ovarian volume, AFC, serum FSH, LH, and AMH were performed for study participants before commencement of chemotherapy and after completion of first and second chemotherapy cycle. Women were followed up 3 and 24&#xa0;months following the completion of chemotherapy.</p> Results <p>A total of 55 women satisfying the inclusion and exclusion conditions were recruited over 2&#xa0;years. The most common malignancy was breast cancer followed by oral, gastrointestinal, and haematological cancers. Statistically significant decline in mean AFC (<i>F</i> = 37.28; <i>p</i> &lt; 0.001) and AMH (<i>p</i>-value &lt; 0.001) levels was observed with alkylating agents, anthracyclines, and platinum-based compounds. Correspondingly, serum FSH and LH levels were significantly elevated to a mean level of 61.44&#xa0;IU (<i>p</i> &lt; 0.001) and 22.38 (<i>p</i>-value &lt; 0.001), respectively, from the baseline value. Only 18.4% women had preservation of menstruation a 3-month follow-up. Among women aged 40 or above, the preservation of menstruation was 98.5% less likely as compared to women aged &lt; 30&#xa0;years (OR 0.015, <i>p</i> = 0.005).</p> Conclusion <p>Female age at the initiation of chemotherapy was the important modulating parameter for the gonadotoxic effect of the chemotherapy. There was a higher trend for loss of menstrual function with alkylating agents, anthracyclines, and platinum-based agents.</p>

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Ovarian Reserve After Chemotherapy: A High Attrition Game—A Prospective Cohort study

  • 期刊论文

  • 发表日期：

    2025年11月22日

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  • Dinesh Kumar,
  • Navdeep Kaur Ghuman,
  • Dharamveer Yadav,
  • Puneet Pareek,
  • Jeewan Ram Vishnoi,
  • Shashank Shekhar,
  • Pratibha Singh

摘要

Objective

The study examined the impact of various chemotherapy regimens on the ovarian reserve of women in reproductive age group. The potential demographic, clinical, and regime-related parameters factors modulating that effect were also studied.

Methods

This prospective cohort study enrolled women planned for chemotherapy for various malignancies, between the age of 18 and 45 years. Ovarian volume, AFC, serum FSH, LH, and AMH were performed for study participants before commencement of chemotherapy and after completion of first and second chemotherapy cycle. Women were followed up 3 and 24 months following the completion of chemotherapy.

Results

A total of 55 women satisfying the inclusion and exclusion conditions were recruited over 2 years. The most common malignancy was breast cancer followed by oral, gastrointestinal, and haematological cancers. Statistically significant decline in mean AFC (F = 37.28; p < 0.001) and AMH (p-value < 0.001) levels was observed with alkylating agents, anthracyclines, and platinum-based compounds. Correspondingly, serum FSH and LH levels were significantly elevated to a mean level of 61.44 IU (p < 0.001) and 22.38 (p-value < 0.001), respectively, from the baseline value. Only 18.4% women had preservation of menstruation a 3-month follow-up. Among women aged 40 or above, the preservation of menstruation was 98.5% less likely as compared to women aged < 30 years (OR 0.015, p = 0.005).

Conclusion

Female age at the initiation of chemotherapy was the important modulating parameter for the gonadotoxic effect of the chemotherapy. There was a higher trend for loss of menstrual function with alkylating agents, anthracyclines, and platinum-based agents.