Anti-Müllerian hormone in pre-menopausal females after ablative radioiodine treatment for differentiated thyroid cancer

Abstract

AMH should replace FSH in the evaluation of gonadal reserve in pre-menopausal thyroid cancer women. At present, age is the only predictor of AMH levels. About one out of two women with a history of thyroid cancer suffers from menstrual dysregulation, but infertility must be considered a low risk.

Cross-sectional and prospective study on anti-Müllerian hormone changes in a cohort of pre-menopausal women with a history of differentiated thyroid cancer

“…AMH levels were only slightly, and not significantly, lower in those patients who had undergone RAI [15]. In both studies, the interval between thyroidectomy and RAI administration and AMH sample collection was of several months: more than 36 months in the Acibucu et al study [14] and 5 years on average in our study [15]. Recently, Yaish et al [16] and Evranos et al [17] designed similar studies in which AMH was evaluated before and 3-12 months after RAI administration in DTC females.…”

“…First, in 45 women aged 36 years on average who had been exposed to RAI, Acibucu et al [14] reported lower AMH levels than in 40 healthy body mass index (BMI)-and agematched females. We [15] measured AMH levels in 34 pre-menopausal women treated with RAI for DTC and compared these with those of 23 age-matched women with DTC who had not received RAI therapy. AMH levels were only slightly, and not significantly, lower in those patients who had undergone RAI [15].…”

“…We [15] measured AMH levels in 34 pre-menopausal women treated with RAI for DTC and compared these with those of 23 age-matched women with DTC who had not received RAI therapy. AMH levels were only slightly, and not significantly, lower in those patients who had undergone RAI [15]. In both studies, the interval between thyroidectomy and RAI administration and AMH sample collection was of several months: more than 36 months in the Acibucu et al study [14] and 5 years on average in our study [15].…”

“…Moreover, at present, while the acute effects of RAI on AMH levels in DTC females can be considered well documented [16,17], the long-term effects are not well defined [14,15]. Small numbers of patients and controls, differences in age between study groups, differences in RAI activities administered to DTC patients, inadequate follow-up, and differences in the sensitivity of AMH assays suggest that further studies are needed in this field.…”

“…The aim of the present study was to increase the number of AMH evaluations in pre-menopausal females with a history of DTC, treated or not with RAI, and to start a prospective AMH evaluation by collecting additional samples from the same patients when no further RAI treatment was given. Since a limitation of our previous study [15] was the lack of a control group of normal premenopausal women with normal thyroid function and the lack of in-house age-related AMH reference values, in the present study a large group of normal pre-menopausal females was recruited in order to ascertain whether AMH changes in DTC were RAI-and thyroid pathology-related or age-related. Chronological age, BMI, therapies, menstrual cycle characteristics, pregnancies, pituitary-gonadal hormones, TSH and f-T4 levels were considered.…”