Evidence map›Paper›PMID 33141175›Full record

ArticleThe Journal of clinical endocrinology and metabolism2021

Beyond Premature Ovarian Insufficiency: Staging Reproductive Aging in Adolescent and Young Adult Cancer Survivors.

Alexa C O Medica, Brian W Whitcomb, Ksenya Shliakhsitsava, Andrew C Dietz, Kelsey Pinson, Christina Lam, Sally A D Romero, Patrick Sluss, Mary D Sammel, H Irene Su

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Alexa C O MedicaDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California.
Brian W WhitcombDepartment of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, Massachusetts.
Ksenya ShliakhsitsavaDivision of Pediatric Hematology and Oncology, University of Texas Southwestern, Dallas, Texas.
Andrew C DietzMoores Cancer Center, University of California, San Diego, La Jolla, California.
Kelsey PinsonDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California.
Christina LamDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California.
Sally A D RomeroMoores Cancer Center and Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
Patrick SlussAnsh Labs, Webster, Texas.
Mary D SammelDivision of Biostatistics and Bioinformatics, School of Public Health, University of Colorado, Denver, Colorado.
H Irene SuDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences and Moores Cancer Center, University of California, San Diego, La Jolla, California.
University of California San Diego · USColorado School of Public Health · USThe University of Texas Southwestern Medical Center · USUniversity of Massachusetts Amherst · US

Funding

The Reproductive Window in Young Adult Cancer SurvivorsR01HD080952 · NICHD · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SU, HUI-CHUN IRENE · 2014 to 2018
$2.6M
NICHD NIH HHS R01 HD080952
6 · The paper itself

Abstract

contextAlthough stages of reproductive aging for women in the general population are well described by STRAW+10 criteria, this is largely unknown for female adolescent and young adult cancer survivors (AYA survivors).

objectiveThis work aimed to evaluate applying STRAW + 10 criteria in AYA survivors using bleeding patterns with and without endocrine biomarkers, and to assess how cancer treatment gonadotoxicity is related to reproductive aging stage.

designThe sample (n = 338) included AYA survivors from the Reproductive Window Study cohort. Menstrual bleeding data and dried-blood spots for antimüllerian hormone (AMH) and follicle-stimulating hormone (FSH) measurements (Ansh DBS enzyme-linked immunosorbent assays) were used for reproductive aging stage assessment. Cancer treatment data were abstracted from medical records.

resultsAmong participants, mean age 34.0 ± 4.5 years and at a mean of 6.9 ± 4.6 years since cancer treatment, the most common cancers were lymphomas (31%), breast (23%), and thyroid (17%). Twenty-nine percent were unclassifiable by STRAW + 10 criteria, occurring more frequently in the first 2 years from treatment. Most unclassifiable survivors exhibited bleeding patterns consistent with the menopausal transition, but had reproductive phase AMH and/or FSH levels. For classifiable survivors (48% peak reproductive, 30% late reproductive, 12% early transition, 3% late transition, and 7% postmenopause), endocrine biomarkers distinguished among peak, early, and late stages within the reproductive and transition phases. Gonadotoxic treatments were associated with more advanced stages.

conclusionsWe demonstrate a novel association between gonadotoxic treatments and advanced stages of reproductive aging. Without endocrine biomarkers, bleeding pattern alone can misclassify AYA survivors into more or less advanced stages. Moreover, a large proportion of AYA survivors exhibited combinations of endocrine biomarkers and bleeding patterns that do not fit the STRAW + 10 criteria, suggesting the need for modified staging for this population.

Indexed as

AgingReproductionAdolescentAdultAnti-Mullerian HormoneAntineoplastic AgentsCancer SurvivorsEndocrine GlandsFemaleFollicle Stimulating HormoneFollow-Up StudiesHumansMenopauseNeoplasmsPrimary Ovarian InsufficiencyPrognosisAnti-Mullerian HormoneAntineoplastic AgentsFollicle Stimulating Hormoneadolescent and young adult cancermenopausal transitionpremature ovarian insufficiencyreproductive agingSTRAW

Identifiers

PMID33141175
PMCPMC7823232
OpenAlexW3096850666

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.