[O-374] ANTI-MULLERIAN HORMONE (AMH) IS DIMINISHED IN FEMALE LYMPHOMA PATIENTS EVEN BEFORE ONCOLOGICAL TREATMENT.
K. E. Dillon, M. D. Sammel, J. P. Ginsberg, J. E. Mersereau, Y. Gosiengfiao, C. R. Gracia. Obstetrics and Gynecology, University of Pennslyvania School of Medicine, Philadelphia, PA; Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA; Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC; Pediatrics, Children's Memorial Hospital, Chicago, IL.
OBJECTIVE: Oncologic diseases present unique challenges for fertility preservation. There is some evidence that response to ovarian stimulation is impaired in patients with a new cancer diagnosis even before cancer therapy. However there is little data measuring early follicular phase hormones in this population. The aim of this study was to assess measures of ovarian reserve in female cancer patients before cancer therapy is initiated.
DESIGN: Baseline assessment of a prospective cohort study.
MATERIALS AND METHODS: Chemo-naïve patients with a new cancer diagnosis and similar age controls had a study visit consisting of early follicular phase hormone measurements and ultrasound measurements. Natural log transformed hormone values and antral follicle count (AFC) were modeled using linear regression adjusted for age and body mass index.
RESULTS: 80 premenopausal female participants (mean age 27 years) with a new cancer diagnosis were compared to 78 similarly-aged controls. Overall, adjusted models showed no differences in follicle-stimulating hormone, lutenizing hormone, estradiol, inhibin B, AMH or AFC in cancer patients compared to controls. Subgroup analysis demonstrated no differences in measures of ovarian reserve for breast (n=30), leukemic (n=5), or sarcoma (n=8) patients compared to controls. However, patients with lymphoma (n=27) demonstrated impaired levels of AMH compared to controls (p=0.016). Analysis restricted to lymphoma patients not taking exogenous hormones (n=21) vs. controls (n=78) confirmed significantly lower AMH (1.5 ng/mL vs. 2.3 ng/mL; p=0.045).
CONCLUSION: Lymphoma is associated with ovarian impairment even before cancer therapy. The outcomes of ovarian stimulation in this population need further investigation for fertility preservation counseling.
Supported by: K01 L:1-CA-133839-03 (CG); 1R01HD062797 (CG), and the Doris Duke Clinical Research Fellowship (KED).
Wednesday, October 24, 2012 4:30 PM
Oral Session: Reproductive Endocrinology: Clinical