Post-chemotherapy serum anti-müllerian hormone level predicts ovarian function recovery.

In the era of precision medicine, the prediction of ovarian function recovery from chemotherapy-induced amenorrhoea using feasible biological markers may be helpful to optimise the treatment strategy for young patients with hormone receptor-positive breast cancer. The purpose of this study was to investigate the accuracy of post-chemotherapy biological markers for predicting the recovery of ovarian function in breast cancer patients of the ASTRRA trial, with chemotherapy-induced amenorrhoea. Using data of 82 participants from a single institution in the ASTRRA trial, the post-chemotherapy serum levels of the anti-müllerian hormone (AMH), estradiol, inhibin B, and other clinical factors associated with chemotherapy-induced amenorrhoea were evaluated. Recovery of ovarian function was defined by the resumption of menstruation manifested by vaginal bleeding. Fifty-two patients regained menstruation within 55 months after enrolment. In univariate analysis, <40 years of age (p=0.009), estradiol ≥37 pg/mL (p=0.003), or AMH ≥800 pg/mL (p=0.026) were associated with recovery of menstruation. On multivariate analysis, estradiol (hazard ratio: 3.171, 95% CI: 1.306-7.699, p=0.011) and AMH (hazard ratio: 2.853, 95% CI: 1.011-8.046, p=0.048) remained as significant independent predictors for resumption of menstruation. The diagnostic accuracy of age, estradiol, and AMH in predicting the resumption of menstruation was 38.3%, 23.3%, and 86.7%, respectively. In conclusion, post-chemotherapy AMH level might be a relatively accurate predictor of the recovery of ovarian function, presented by resumption of menstruation in breast cancer patients with chemotherapy-induced amenorrhoea.