The Effects of Chemotherapy on the Levels of Serum Anti-Müllerian Hormone in Patients with Gestational Trophoblastic Neoplasia

Zamani, Mehrangiz; Mohsenpour, Fatemeh; Torkzaban, Faezeh; Atrvash, Nazanin; Majlesi, Amir; Torkzaban, Amirfazel

doi:10.18502/jri.v24i1.11908

The Effects of Chemotherapy on the Levels of Serum Anti-Müllerian Hormone in Patients with Gestational Trophoblastic Neoplasia

Authors

Mehrangiz Zamani ¹

Fatemeh Mohsenpour ¹

Faezeh Torkzaban ²

Nazanin Atrvash ¹

Amir Majlesi ³

Amirfazel Torkzaban ⁴

¹ Fatemieh Hospital, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran, Hamadan, Iran

² Faculty of Rehabilitation, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran

³ Besat Hospital, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran

⁴ National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

10.18502/jri.v24i1.11908

Abstract

Background: Gestational trophoblastic neoplasia (GTN) is a group of tumors highly responsive to chemotherapy. It has been suggested that cancer therapies have detrimental effects on female fertility. Anti-Müllerian hormone (AMH) is considered fertility potential and ovarian reserves in women. The aim of this study was to compare serum AMH levels between the patients with GTN treated with chemotherapy and the patients with hydatidiform mole who underwent suction curettage without receiving any chemotherapy. Methods: In 35 patients with GTN, serum AMH levels were measured before suction curettage and after the administration of chemotherapy and compared with serum AMH levels measured in 35 patients with hydatidiform mole, who did not receive any chemotherapy as a control. In controls, serum levels of AMH were measured before suction curettage and at the time when beta human chorionic gonadotrophin (ß-hCG) levels approached zero concentration. Results: The mean serum AMH levels in the GTN group were significantly lower than those measured in the control group after chemotherapy. In addition, serum AMH levels measured after intervention in each group significantly decreased compared to the basal levels (p=0.034). Serum AMH levels showed significant differences between the patients who received chemotherapy regimens with methotrexate (MTX) alone, actinomycin-D (Act-D) alone, or the combination of MTX and Act-D (p=0.001). Conclusion: Our study showed that fertility preservation is of great importance in patients with GTN treated with chemotherapy. Furthermore, both MTX and Act-D could have potential adverse effects on ovarian reserve.

Keywords

anti

Mullerian Hormone

Chemotherapy

Fertility

Gestational trophoblastic neoplasia

hydatidiform mole

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