Ghorani Ehsan, Ramaswami Ramya, Smith Richard J, Savage Philip M, Seckl Michael J
J Reprod Med. 2016 May-Jun;61(5-6):205-9.
Serum anti-Müllerian hormone (AMH) is an emerging indicator of ovarian reserve which may be predictive of reproductive capacity. Although AMH levels decline with chemotherapy, little is known about the relevance of this to subsequent fertility, and we set out to evaluate this association in patients with gestational trophoblastic neoplasia (GTN).
The GTN database of our national referral center was screened from 2008-2012 for patients undergoing AMH testing, and subsequent fertility outcomes were reviewed.
Of 470 treated patients, 3 underwent AMH testing for evaluation of potential subfertility 4-13 months following multiagent chemotherapy, with levels rangingfrom 0.07-4.62 pmol/L. All 3 were counseled by independent fertility specialists of the low probability of subsequent conception but went on to initiate spontaneously conceived pregnancies within 2-9 months, resulting in healthy infants.
Low serum AMH is not a reliable predictor of reduced short-term fertility postchemotherapy for GTN and should be interpreted with caution when counseling patients in this setting.
血清抗苗勒管激素(AMH)是一种新出现的卵巢储备指标,可能预测生殖能力。虽然化疗会使AMH水平下降,但对于这与后续生育能力的相关性知之甚少,我们着手评估妊娠滋养细胞肿瘤(GTN)患者中的这种关联。
对我国转诊中心2008年至2012年期间接受AMH检测的GTN患者数据库进行筛查,并回顾其后续生育结局。
在470例接受治疗的患者中,3例在多药化疗后4至13个月接受了AMH检测以评估潜在的生育力低下,其水平为0.07至4.62 pmol/L。所有3例患者均由独立的生育专家告知后续受孕概率较低,但她们在2至9个月内自然受孕并成功妊娠,产下健康婴儿。
血清AMH水平低并非GTN化疗后短期生育力降低的可靠预测指标,在为处于这种情况的患者提供咨询时应谨慎解读。