Khadija Kacem Berjeb1, Linda Debbabi2, Marouen Braham3, Zeineb Zemni3, Sana Chtourou2, Hela Hannachi4, Manel Hamdoun4, Mouna Ayadi5, Karima Kacem6, Fethi Zhioua3, Anis Fadhlaoui3, Olfa Bahri4, Nozha Chakroun2. 1. University of Medicine of Tunis, Laboratory of Reproductive Biology and Cytogenetic Laboratory. Aziza Othmana Hospital, Tunis, Tunisia. Electronic address: Khadija.berjeb@yahoo.fr. 2. University of Medicine of Tunis, Laboratory of Reproductive Biology and Cytogenetic Laboratory. Aziza Othmana Hospital, Tunis, Tunisia. 3. University of Medicine of Tunis, Gynecology and Obstetrics Department. Aziza Othmana Hospital, Tunis, Tunisia. 4. University of Medicine of Tunis, Biochemistry and Microbiology Laboratory, Aziza Othmana Hospital, Tunis, Tunisia. 5. University of Medicine of Tunis, Medical Oncology Department. Salah Azaiz Institute, Tunis, Tunisia. 6. University of Medicine of Tunis, Hematology Department. Aziza Othmana Hospital, Tunis, Tunisia.
Abstract
BACKGROUND: Progress in oncology has improved patient survival. However, cancer chemotherapy can be gonadotoxic and affect their fertility. Recourse to fertility preservation before starting these treatments is therefore necessary in order to allow a better life quality after survival. The aim of this work was to study the impact of chemotherapy on ovarian reserve by AMH measurement. METHODS: This is a descriptive and longitudinal study from 2015 to 2018 carried out at Aziza Othmana hospital ART center in Tunis on patient aged less than 41 years who were candidates for fertility preservation. Patients included had AMH measurement prior to cancer treatment. We called them back to follow up the AMH level after chemotherapy. The AMH assay was performed by electrochemilumiescence technique. At the end, only 66 patients met the inclusion criteria. RESULTS: The most frequent pathologies were Hodgkin's lymphoma and breast cancer. The mean age of patients was 26.7 ± 6.8. The most used chemotherapy protocols were BEACOPP, ABVD or the combination of both in lymphoma and FEC + TXT for breast cancer treatment. A significant difference between AMH before and after chemotherapy was found for BEACOPP and FEC + TXT protocols (p < 10 3). The patient's age was correlated with the AMH decrease after chemotherapy (r = 0.577, p < 10 3). CONCLUSION: Our results showed that the high risk gonadotoxicity protocols were BEACOPP for lymphoma treatment and FEC + TXT for breast cancer treatment. However, studies with a larger sample and more time extended monitoring are necessary for a better gonadotoxicity understanding of the cancer treatments available today.
BACKGROUND: Progress in oncology has improved patient survival. However, cancer chemotherapy can be gonadotoxic and affect their fertility. Recourse to fertility preservation before starting these treatments is therefore necessary in order to allow a better life quality after survival. The aim of this work was to study the impact of chemotherapy on ovarian reserve by AMH measurement. METHODS: This is a descriptive and longitudinal study from 2015 to 2018 carried out at Aziza Othmana hospital ART center in Tunis on patient aged less than 41 years who were candidates for fertility preservation. Patients included had AMH measurement prior to cancer treatment. We called them back to follow up the AMH level after chemotherapy. The AMH assay was performed by electrochemilumiescence technique. At the end, only 66 patients met the inclusion criteria. RESULTS: The most frequent pathologies were Hodgkin's lymphoma and breast cancer. The mean age of patients was 26.7 ± 6.8. The most used chemotherapy protocols were BEACOPP, ABVD or the combination of both in lymphoma and FEC + TXT for breast cancer treatment. A significant difference between AMH before and after chemotherapy was found for BEACOPP and FEC + TXT protocols (p < 10 3). The patient's age was correlated with the AMH decrease after chemotherapy (r = 0.577, p < 10 3). CONCLUSION: Our results showed that the high risk gonadotoxicity protocols were BEACOPP for lymphoma treatment and FEC + TXT for breast cancer treatment. However, studies with a larger sample and more time extended monitoring are necessary for a better gonadotoxicity understanding of the cancer treatments available today.