[Ovarian function in young women after anticancer treatment in childhood]

We investigated pituitary-ovarian function in young women after treatment for different cancers in prepubertal and pubertal periods, with or without radiotherapy of infradiaphragmatic areas.

We analyzed the values of follicle-stimulating hormone (FSH) luteinizing hormone (LH), estradiol (E2), inhibin B and anti-müllerian hormone (AMH) in the group of 28 young women aged 18.6 +/- 4.7 years, who had been treated for Hodgkin's Lymphoma HL (n=16), nephroblastoma (n=7), soft tissue sarcoma (n=4), neuroblastoma (n=1). Abdominal irradiation was given in fifteen survivors. Control group was composed of ten healthy women at similar age.

In the whole group the mean levels of FSH, LH and E2 did not differ from the control group, but in the subgroup irradiated infradiaphragmatically FSH concentration was higher than in the control group (8.06+/-3.28 vs 5.8+/-2.03 mIU/ml) p=0.042, particularly after HL treatment (8.53+/-3.25 mIU/ml), p=0.045. Mean AMH levels were significantly lower in the whole analyzed group than in the control one (22.8+/-16.3 vs 29.4+/-13.2 pmol/l) p=0.036, particularly in the subgroup irradiated for abdomen (17.2+/-14.9 pmol/l) p=0.025. Inhibin B was also lower in the whole group, (27.98+/-17.8 ng/l vs 47.9+/-26.4 ng/l) p=0.035, and in the subgroup with non-irradiated abdomen 25.9+/-14.1 ng/l, p=0.01. We did not observe the influence of age at treatment (prepubertal vs pubertal period) on the values of analyzed hormones. We found a correlation between AMH and inhibin B.

In young women after anti-cancer treatment, with normal menstrual cycles, the signs of ovarian dysfunction and diminished ovarian reserve are observed. This situation can lead to a shorter period of fertility. Those women should be informed about their reproductive potential.