Toward a better follow up of ovarian recovery in young women after chemotherapy with a hypersensitive antimullerian hormone assay

Capsule:
The hypersensitive PicoAMH assay, by its capacity to detect low levels of blood AMH, allows a more accurate prediction of menstrual cycle recovery in young women after chemotherapy.

Authors:
Christine Decanter, M.D., Maeliss Peigne, M.D., Audrey Mailliez, M.D., Franck Morchhauser, M.D., Audrey Dassonneville, Dewailly Didier, M.D., Pascal Pigny, M.D.

Volume 102, Issue 2, Pages 483–487

Abstract:

Objective:
To evaluate the utility of a hypersensitive assay for measuring low antimüllerian hormone (AMH) levels in young cancer patients during the ovarian recovery phase of their chemotherapy.

Design:
Retrospective study.

Setting:
Academic medical center.

Patient(s):
Fifty-eight samples drawn at least 3 months after the end of chemotherapy in 30 women having either breast cancer (n = 13) or hematologic malignancies (n = 17) were selected to constitute two equally size groups: amenorrhea (n = 30 samples) or spontaneous cycle (n = 28 samples).

Intervention(s):
None.

Main Outcome Measure(s):
Serum AMH levels were measured by a conventional AMH ELISA (EIA AMH/MIS) and a hypersensitive ELISA (PicoAMH, AnshLabs) on the same sample.

Result(s):
Using a conventional assay, serum AMH was detectable (≥3 pmol/L) in 6.7% and in 10.7% of the samples corresponding to amenorrheic or cycling patients, respectively (nonsignificant). By contrast, with PicoAMH, serum AMH was detectable (≥0.07 pmol/L) in 71.4% of the samples from cycling women vs. 16.7% of the samples from amenorrheic patients. Multivariate regression analysis showed that among putative contributors, only the menstrual status (r = 0.307) and serum FSH level (r = −0.546) were independently correlated to a detectable serum AMH with the picoAMH assay exclusively.

Conclusion(s):
The picoAMH assay, allowing measurement of very low AMH concentrations in human serum, should refine postchemotherapy ovarian follow-up in young women.

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