Original article
Reduced pretreatment ovarian reserve in premenopausal female patients with Hodgkin lymphoma or non-Hodgkin-lymphoma—evaluation by using antimüllerian hormone and retrieved oocytes

https://doi.org/10.1016/j.fertnstert.2012.04.021Get rights and content

Objective

To study whether the ovarian reserve in female lymphoma patients is already reduced before the start of chemotherapy.

Design

Age-matched control study.

Setting

Women's university hospital.

Patient(s)

Female patients aged <40 years with the initial diagnosis of lymphoma (study group) were compared with age-matched healthy volunteers (control group). Eighty-four female patients with breast cancer and 64 patients with lymphoma who underwent ovarian hormonal stimulation as a fertility-preserving method before the start of chemotherapy.

Intervention(s)

Measurement of antimüllerian-hormone (AMH) levels. Ovarian hormonal stimulation to retrieve oocytes.

Main Outcome Measure(s)

AMH levels of the lymphoma patients and the healthy volunteers were compared. Numbers of retrieved oocytes after hormonal stimulation in patients with breast cancer and those with lymphoma were compared.

Result(s)

Female lymphoma patients have significantly lower AMH levels than healthy age-matched controls: mean value of AMH was 2.06 ng/mL in the study group versus 3.20 ng/mL in the control group. Analysis of the stimulation results showed that in significantly younger patients with lymphoma, significantly fewer oocytes could be retrieved in comparison to those with breast cancer.

Conclusion(s)

Ovarian reserve is reduced in female patients affected by lymphoma even before the start of chemotherapy. Proper counseling and implementation of fertility-preserving methods is highly recommended.

Section snippets

Materials and methods

Between January 2007 and November 2011, a total of 49 female patients with an initial diagnosis of HL or NHL presented for counseling on fertility preservation methods before receiving cytotoxic chemotherapy. Of these 49 patients, 38 agreed to take part in this study (i.e., study group). Blood was taken as part of the consultation to measure AMH levels as a marker of the ovarian reserve.

The control group was composed of healthy, voluntary, age-matched women with a normal body mass index and a

Results

The mean age of the patients in the study group and those of the control group was 25.5 years (range 18–33 years). Thirty-one patients were affected by Hodgkin disease and seven by a non-Hodgkin lymphoma. Nine patients were found to have breast cancer symptoms at the time of diagnosis.

Twenty-three patients had stage I/II disease and 15 patients stage III/IV. The mean age of the patients with stage I/II disease was 25.22 years (range 18–38 years) and was 25.93 years (range 20–33 years) in the

Discussion

It has been shown that the sperm quality in men with HL or NHL is already significantly reduced before the start of chemotherapy 9, 10, 11, 12. We therefore analyzed whether reduced fertility in the form of a reduced ovarian reserve also exists in women with HL and NHL. Antimüllerian hormone has established itself as a valuable parameter that reflects the ovarian reserve well (14). Evaluation of AMH levels in our collective of lymphoma patients and com-parison with healthy age-matched controls

References (22)

  • L.R. Schover et al.

    Having children after cancer. A pilot survey of survivors' attitude and experiences

    Cancer

    (1999)
  • Cited by (0)

    B.L. has nothing to disclose. T.F. has nothing to disclose. M.v.W. has nothing to disclose. M.S. has nothing to disclose. S.H. has nothing to disclose. J.H. has nothing to disclose. M.H. has nothing to disclose.

    View full text