Inhibin B and anti-Müllerian hormone as markers of gonadal function after hematopoietic cell transplantation during childhood

Abstract

BackgroundIt is difficult to predict the reproductive capacity of children given hematopoietic cell transplantation (HCT) before pubertal age because the plasma concentrations of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are not informative and no spermogram can be done.MethodsWe classified the gonadal function of 38 boys and 34 girls given HCT during childhood who had reached pubertal age according to their pubertal development and FSH and LH and compared this to their plasma inhibin B and anti-Müllerian hormone (AMH).ResultsTen (26%) boys had normal testicular function, 16 (42%) had isolated tubular failure and 12 (32%) also had Leydig cell failure. All 16 boys given melphalan had tubular failure. AMH were normal in 25 patients and decreased in 6, all of whom had increased FSH and low inhibin B.Seven (21%) girls had normal ovarian function, 11 (32%) had partial and 16 (47%) complete ovarian failure. 7/8 girls given busulfan had increased FSH and LH and 7/8 had low inhibin B. AMH indicated that ovarian function was impaired in all girls.FSH and inhibin B were negatively correlated in boys (P < 0.0001) and girls (P = 0.0006). Neither the age at HCT nor the interval between HCT and evaluation influenced gonadal function.ConclusionThe concordance between FSH and inhibin B suggests that inhibin B may help in counselling at pubertal age. In boys, AMH were difficult to use as they normally decrease when testosterone increases at puberty. In girls, low AMH suggest that there is major loss of primordial follicles.

Testicular function in patients with regular blood transfusion for thalassemia major

“…The evaluation of this hormone does not require a stimulation test. Serum AMH levels have been reported useful to assess testicular function in many conditions including isolated cryptorchidism, anorchia, childhood cancer survivors, and after hematopoietic cell transplantation [17][18][19][20]. Serum AMH levels elevate and become stable during prepuberty and then decrease after the onset of puberty [15,16].…”

“…Serum AMH level is high during childhood and declines during puberty as a result of down-regulation by increasing testosterone level [15,16]. Serum AMH level is a useful tool with which to assess testicular function in various conditions such as isolated cryptorchidism, anorchia, childhood cancer survivors and after hematopoietic cell transplantation [17][18][19][20].…”

Gonadal and uterine function in female survivors treated by chemotherapy, radiotherapy, and/or bone marrow transplantation for childhood malignant and non‐malignant diseases

“…4,5 Pelvic irradiation in childhood is associated with a marked reduction of uterine volume, as measured ultrasonographically upon reaching reproductive age. 1 In turn, reduced uterine volume increases the risks of miscarriage, preterm delivery, and low birthweight in newborns.…”

Endocrine and reproductive abnormalities in the men treated for medulloblastoma and acute lymphoblastic leukemia in the childhood

“…По данным УЗИ органов мошонки, у пациентов после терапии МБ Ме общего объема яичек соста-вила 10,9 мл (10,2-15,5), а после терапии ОЛЛ -21,95 мл (18)(19)(20)(21)(22)(23)(24)6). В норме суммарный объем яи-чек составляет 40-50 мл [7,8].…”

“…Уро-вень ингибина В был ниже 80 нг/мл у 2 (33,3%) па-циентов, перенесших терапию по поводу ОЛЛ, и у 15 (88%), перенесших терапию по поводу МБ. Для более детального анализа вопроса необходимо ис-следование спермограммы [20].…”