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

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

doi:10.18502/jri.v24i1.11908

Mehrangiz Zamani Fatemieh Hospital, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
Fatemeh Mohsenpour Fatemieh Hospital, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
Faezeh Torkzaban Faculty of Rehabilitation, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
Nazanin Atrvash Faculty of Rehabilitation, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
Amir Majlesi Besat Hospital, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
Amirfazel Torkzaban National Nutrition and Food Technology Research Institute, Shahid Beheshti University, Tehran, Iran

DOI: https://doi.org/10.18502/jri.v24i1.11908

Keywords: Anti-Müllerian hormone, Chemotherapy, Fertility, Gestational trophoblastic neoplasia, Hydatidiform mole.

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.