Anti-Mullerian hormone follow-up in young women treated by chemotherapy for lymphoma: preliminary results

Susceptibility of the ovarian reserve to chemotherapy is highly variable from one patient to another and poorly documented. To better characterize the evolution of follicular depletion in patients treated for lymphoma, serum anti-Mullerian hormone (AMH) assay was used. A total of 30 young women (mean age 24 years) were prospectively recruited before initiation of chemotherapy for lymphoma. They were assigned either to an adriamycin, bleomycin, vinblastine and dacarbazine protocol (ABVD group) or to a protocol that included cyclophosphamide (non-ABVD group). AMH assays were performed before and during chemotherapy, and then every 3 months after the end of treatment for a period of 1 year. In all patients, AMH concentrations fell drastically just after the start of chemotherapy and were close to the detection limit at the end of the treatment. In the ABVD group, AMH concentrations increased from the third month after the end of chemotherapy and returned to pretreatment values 12 months after the end of chemotherapy. Conversely, no significant change was observed in the non-ABVD group throughout the follow-up period. In conclusion, longitudinal analysis of AMH during chemotherapy highlights differences between protocols that could contribute to an understanding of ovarian toxicity and, ultimately, be useful in fertility preservation counselling. (C) 2009, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.