Ovarian Toxicity in Breast Cancer Survivors

The long-term natural history of ovarian reserve after adjuvant chemotherapy for breast cancer has been poorly described. We recruited 52 breast cancer survivors treated with adjuvant chemotherapy before 40 years of age who remained premenopausal after chemotherapy treatment. Twenty (38.5%) were more than five years out from treatment. Ovarian reserve estimates were compared with a control group. Anti-Müllerian hormone (AMH), follicle stimulating hormone and luteinizing hormone demonstrated significant differences consistent with reduced ovarian reserve in breast cancer survivors. Mean AMH was 6.65 pmol/l in survivors compared to 17.43 in controls (p < 0.001). Attained age and age at the time of treatment were correlated with AMH levels in breast cancer survivors. Conclusion: Ovarian reserve is significantly reduced in young breast cancer survivors. Age is the major predictor of AMH level in survivors. A 35 year old breast cancer survivor has an AMH level similar to a 45 year old control.MAS