Anti-Müllerian hormone in breast cancer patients treated with chemotherapy: a retrospective evaluation of subsequent pregnancies

Reprod Biomed Online. 2016 Mar;32(3):299-307. doi: 10.1016/j.rbmo.2015.12.008. Epub 2016 Jan 6.

Abstract

Few studies have reported reproductive outcomes after breast cancer chemotherapy. The relationship between anti-Müllerian hormone (AMH) concentrations and the occurrence of subsequent pregnancies in women after chemotherapy for breast cancer was investigated. Women aged 18-43 years treated with chemotherapy for invasive breast cancer between May 2005 and January 2011 were retrospectively identified. Exclusion criteria were previous gonadotoxic treatment, oophorectomy or hysterectomy. Measurement of AMH took place before, during chemotherapy and at distant time points after the end of chemotherapy (4 months to 5.5 years). Seventeen out of 134 patients experienced 28 spontaneous pregnancies (median follow-up: 59 months). Neither baseline AMH (divided into quartiles) nor end-of-chemotherapy AMH (detectable versus undetectable) were significantly associated with the occurrence of pregnancy. Chemotherapy regimen with anthracyclines was associated with a greater probability of pregnancy compared with a taxane-containing regimen (hazard ratio 4.75; (95% CI 1.76 to 12.8); P = 0.002). Five-year disease-free survival and overall survival rates were 60% (95% CI: 51 to 70; relapse, n = 48) and 88% (95% CI 82 to 95; deaths, n = 21), respectively. AMH did not predict the occurrence of pregnancy. Additional studies assessing ovarian reserve and reproductive outcomes after breast cancer are required.

Keywords: anti-Müllerian hormone; breast cancer; chemotherapy; pregnancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anthracyclines / adverse effects
  • Anthracyclines / therapeutic use
  • Anti-Mullerian Hormone / blood*
  • Breast Neoplasms / drug therapy*
  • Bridged-Ring Compounds / adverse effects
  • Bridged-Ring Compounds / therapeutic use
  • Disease-Free Survival
  • Female
  • Fertility Preservation*
  • Humans
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Retrospective Studies
  • Survival Analysis
  • Taxoids / adverse effects
  • Taxoids / therapeutic use

Substances

  • Anthracyclines
  • Bridged-Ring Compounds
  • Taxoids
  • taxane
  • Anti-Mullerian Hormone