Evaluation of ovarian reserve before and after chemotherapy

Berjeb, Khadija Kacem; Debbabi, Linda; Braham, Marouen; Zemni, Zeineb; Chtourou, Sana; Hannachi, Hela; Hamdoun, Manel; Ayadi, Mouna; Kacem, Karima; Zhioua, Fethi; Fadhlaoui, Anis; Bahri, Olfa; Chakroun, N.

doi:10.1016/j.jogoh.2020.102035

Cited by 16 publications

(28 citation statements)

References 19 publications

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“…One article was additionally added after hand-searching the references of the included studies [ 8 ]. A total of 18 studies were deemed eligible for this systematic review and meta-analysis [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Anderson et al carried out two studies on the same population but with different follow-up periods; thus, both studies were included [ 10 , 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…The main characteristics of the included studies are shown in Supplementary Material (Tables S2 and S3) . Nine studies (50%) were carried out in Europe [ 10 , 11 , 15 , 16 , 18 , 21 , 22 , 23 , 24 ], three (16%) were carried out in the USA [ 17 , 20 , 25 ], four (22%) were carried out in Asia [ 8 , 9 , 12 , 19 ], one (6%) was carried out in Africa [ 14 ] and one (6%) was carried out in South America [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…All included studies had a cohort design [ 8 , 9 , 10 , 11 , 13 , 14 , 15 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ], except for three RCT [ 16 , 24 , 25 ] and one case–control study [ 12 ]. The study by Trapp et al was a sub-analysis of the SUCCESS-A study [ 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…The sample size varied from 23 [ 13 ] to 250 patients [ 15 ], for a total of 1219 women. The mean age varied from 26 [ 13 ] to 41 [ 10 , 11 ].…”

Section: Resultsmentioning

confidence: 99%

“…AMH is superior in terms of accuracy compared to other conventional indicators of ovarian function such as menstruation, estradiol or FSH [ 6 , 7 ]. Recently, a growing body of literature has been published on the effect of chemotherapy on the ovarian reserve in women with BC, assessed by AMH [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. The summarization and synthesis of these results could provide BC patients and healthcare professionals with crucial information on the reproductive health consequences of chemotherapy treatment and the possibility of achieving pregnancy after completion of endocrine therapy.…”

Section: Introductionmentioning

confidence: 99%

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Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Romito¹,

Bove²,

Romito³

et al. 2021

JPM

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Background: Worldwide, breast cancer (BC) is the most common malignancy in the female population. In recent years, its diagnosis in young women has increased, together with a growing desire to become pregnant later in life. Although there is evidence about the detrimental effect of chemotherapy (CT) on the menses cycle, a practical tool to measure ovarian reserve is still missing. Recently, anti-Mullerian hormone (AMH) has been considered a good surrogate for ovarian reserve. The main objective of this paper is to evaluate the effect of CT on AMH value. Methods: A systematic review and meta-analysis were conducted on the PubMed and Scopus electronic databases on articles retrieved from inception until February 2021. Trials evaluating ovarian reserves before and after CT in BC were included. We excluded case reports, case-series with fewer than ten patients, reviews (narrative or systematic), communications and perspectives. Studies in languages other than English or with polycystic ovarian syndrome (PCOS) patients were also excluded. AMH reduction was the main endpoint. Egger’s and Begg’s tests were used to assess the risk of publication bias. Results: Eighteen trials were included from the 833 examined. A statistically significant decline in serum AMH concentration was found after CT, persisting even after years, with an overall reduction of −1.97 (95% CI: −3.12, −0.82). No significant differences in ovarian reserve loss were found in the BRCA1/2 mutation carriers compared to wild-type patients. Conclusions: Although this study has some limitations, including publication bias, failure to stratify the results by some important factors and low to medium quality of the studies included, this metanalysis demonstrates that the level of AMH markedly falls after CT in BC patients, corresponding to a reduction in ovarian reserve. These findings should be routinely discussed during oncofertility counseling and used to guide fertility preservation choices in young women before starting treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The sample size varied from 23 [ 13 ] to 250 patients [ 15 ], for a total of 1219 women. The mean age varied from 26 [ 13 ] to 41 [ 10 , 11 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Romito¹,

Bove²,

Romito³

et al. 2021

JPM

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Sleep Deprivation Triggers the Excessive Activation of Ovarian Primordial Follicles via β2 Adrenergic Receptor Signaling

Weng,

Hong,

Zhang

et al. 2024

Advanced Science

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Sleep deprivation (SD) is observed to adversely affect the reproductive health of women. However, its precise physiological mechanisms remain largely elusive. In this study, using a mouse model of SD, it is demonstrated that SD induces the depletion of ovarian primordial follicles, a phenomenon not attributed to immune‐mediated attacks or sympathetic nervous system activation. Rather, the excessive secretion of stress hormones, namely norepinephrine (NE) and epinephrine (E), by overactive adrenal glands, has emerged as a key mediator. The communication pathway mediated by the KIT ligand (KITL)‐KIT between granulosa cells and oocytes plays a pivotal role in primordial follicle activation. SD heightened the levels of NE/E that stimulates the activation of the KITL‐KIT/PI3K and mTOR signaling cascade in an β2 adrenergic receptor (ADRB2)‐dependent manner, thereby promoting primordial follicle activation and consequent primordial follicle loss in vivo. In vitro experiments further corroborate these observations, revealing that ADRB2 upregulates KITL expression in granulosa cells via the activation of the downstream cAMP/PKA pathway. Together, these results reveal the significant involvement of ADRB2 signaling in the depletion of ovarian primordial follicles under sleep‐deprived conditions. Additionally, ADRB2 antagonists are proposed for the treatment or prevention of excessive activation of primordial follicles induced by SD.

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Reproduction patterns among classical Hodgkin lymphoma survivors treated with BEACOPP and ABVD in Sweden, Denmark and Norway—A population‐based matched cohort study

Entrop

Weibull

Smedby

et al. 2023

Intl Journal of Cancer

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Childbirth rates in classical Hodgkin lymphoma (cHL) survivors have historically been reduced compared to the general population. Understanding if contemporary treatment protocols are associated with reduced fertility is crucial as treatment guidelines shift toward more liberal use of intensive chemotherapy. We identified 2834 individuals aged 18‐40 years with cHL in Swedish and Danish lymphoma registers, and in the clinical database at Oslo University Hospital diagnosed 1995‐2018, who were linked to national medical birth registers. Cox regression adjusted for stage, performance status, year, and age at diagnosis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) contrasting time to first childbirth by treatment groups (ABVD, 2‐4 BEACOPP, 6‐8 BEACOPP) up to 10 years after diagnosis. Overall, 74.8% of patients were treated with ABVD, 3.1% with 2‐4 BEACOPP and 11.2% with 6‐8 BEACOPP. Adjusted HRs comparing childbirth rates in individuals treated with 6‐8 BEACOPP, and 2‐4 BEACOPP to ABVD were 0.53 (CI: 0.36‐0.77) and 0.33 (CI: 0.12‐0.91) for males, and 0.91 (CI: 0.61‐1.34) and 0.38 (CI: 0.12‐1.21) for females. Cumulative incidence of childbirths after 10 years was 19.8% (CI: 14.5%‐27.0%) for males and 34.3% (CI: 25.8%‐45.6%) for females treated with 6‐8 BEACOPP. Proportions of children born after assisted reproductive technique (ART) treatments were 77.4% (CI: 60.2‐88.6%) for males following 6‐8 BEACOPP, and <11% for females. Among ABVD treated patients the corresponding proportions were 12.2% (CI: 8.5%‐17.3%) and 10.6% (CI: 7.4%‐14.9%). BEACOPP treatment is associated with decreased childbirth rates compared to ABVD in male, but not female, cHL patients, despite widespread access to ART in the Nordics.

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Evaluation of ovarian reserve before and after chemotherapy

Cited by 16 publications

References 19 publications

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis

Sleep Deprivation Triggers the Excessive Activation of Ovarian Primordial Follicles via β2 Adrenergic Receptor Signaling

Reproduction patterns among classical Hodgkin lymphoma survivors treated with BEACOPP and ABVD in Sweden, Denmark and Norway—A population‐based matched cohort study

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