Assessment of ovarian reserve with anti-Mullerian hormone in women following allogeneic hematopoietic cell transplantation

Abstract

Assessment of ovarian reserve with anti-Mullerian hormone in women following allogeneic hematopoietic cell transplantation A.H. Kaya 1 , E. Tekgunduz 1 , S. Akpınar 1 , G. Bozdağ 2 , T.N. Yiğenoğlu 1 , A. Merdin 1 , S. Namdaroglu 1 , O. Kayıkcı 1 , F. Altuntaş 1 1Hematology Clinic and Bone Marrow Transplantation Unit, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 2Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara (Turkey) Summary Introduction: Severe ovarian failure and persistent infertility have could be seen in females following allogeneic hematopoietic cell transplantation (allo-HCT.) In this study, the authors aimed to determine the effectiveness of AMH on assessment of ovarian reserve in long-term survivors after allo-HCT. Material and Methods: Female patients, who underwent allo-HCT between August 2009 and February 2016, were retrospectively evaluated for ovarian capacity in long-term follow-up. Twenty-one female patients with a median age of 34 (22-45) years were included in the study. The serum levels of estrogen (E2), follicle stimulated hormone (FSH), luteinizing hormone (LH), and AMH were analysed. Results: The median duration of post-transplant follow-up was 37 (12-84) months. Primary ovarian failure (POF) was detected in eight (38,1%) and 19 (90,4%) cases in the pre-transplant and post-transplant period, respectively. It was found that no menstruation cycles were observed in 18 cases with low AMH levels. Discussion: Regular menstrual cycles may not guarantee the fertilization in the post-transplant period. Combined analysis of hormonal investigations, antral follicle count by vaginal USG, and evaluation of serum AMH levels may be preferred to demonstrate the presence of POF. Key words: Anti-Mullerian hormone; Ovarian reserve; Allogeneic stem cell transplantation.