Prediction of ovarian function recovery in young breast cancer patients after protection with gonadotropin-releasing hormone agonist during chemotherapy

摘要

PurposeThis study evaluated predictive factors for recovery of ovarian function after ovarian protection by GnRH agonist during chemotherapy in young breast cancer patients.MethodsThis prospective cohort study analyzed 105 young breast cancer patients who were studied longitudinally after receiving GnRH agonist during cyclophosphamide-based chemotherapy for ovarian protection. Associations between pretreatment hormones, clinical factors, and recovery of ovarian function (resumption of menstruation or anti-Mullerian hormone (AMH)1ng/ml) were evaluated at 12 months and long-term follow-up after completion of chemotherapy.ResultsMean age was 32years (range 23-42years). In multivariate analyses, tamoxifen use (P=0.035) and pretreatment follicle-stimulating hormone (FSH) (P=0.032) were predictive of resumption of menstruation, and age (P=0.019), tamoxifen use (P=0.022), pretreatment FSH (P0.001), and AMH (P=0.040) were predictors for AMH1ng/ml at 12months. In addition, pretreatment AMH was a predictor for AMH1ng/ml after long-term follow-up. Receiver operating characteristic curve analyses gave area under the curve of 0.805 for resumption of menstruation and 0.903 for serum AMH concentration 1ng/ml at 12 months, when age, tamoxifen use, pretreatment FSH, and AMH were combined.ConclusionPretreatment AMH (3.26ng/ml), age (33.9years), pretreatment FSH (5.5IU/l), and tamoxifen use are useful predictors for AMH1ng/ml at 12months after GnRH agonist. This finding will support patient and clinician decision-making regarding fertility preservation.