Evidence map›Paper›PMID 39133666›Full record

ArticlePloS one2024

Anti-Müllerian hormone and fertility in women after childhood cancer treatment: Association with current infertility risk classifications.

Anna Nyström, Helena Mörse, Ingrid Øra, Emir Henic, Jacob Engellau, Elinore Wieslander, Andrzej Tomaszewicz, Maria Elfving

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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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

8 authors.

Anna NyströmDepartment of Clinical Sciences Lund, Paediatrics, Lund University, Lund, Sweden.ORCID 0009-0001-9147-6287
Helena MörseDepartment of Clinical Sciences Lund, Paediatrics, Lund University, Lund, Sweden.
Ingrid ØraDepartment of Clinical Sciences Lund, Paediatrics, Lund University, Lund, Sweden.ORCID 0000-0002-3931-4125
Emir HenicDepartment of Translational Medicine, Reproductive Medicine, Lund University, Malmö, Sweden.
Jacob EngellauDepartment of Clinical Sciences Lund, Systemic Radiation Therapy, Lund University, Lund, Sweden.
Elinore WieslanderHaematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.
Andrzej TomaszewiczHaematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.
Maria ElfvingDepartment of Clinical Sciences Lund, Paediatrics, Lund University, Lund, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo identify childhood cancer survivors (CCSs) at risk of premature ovarian insufficiency (POI) and impaired fertility is important given its impact on quality of life. The aim of this study was to assess ovarian markers and fertility outcomes in adult female CCSs. We used the Swedish and the PanCareLIFE classifications for infertility risk grouping.

methods167 CCSs, at median age 34.6 years (19.3-57.8) with a median follow-up time of 25.4 years (11.6-41.3), and 164 healthy matched controls were included in this cross-sectional study. We assessed anti-Müllerian hormone (AMH) levels, antral follicle count (AFC), ovarian volume (OV), and fertility outcomes. Based on gonadotoxic treatments given, CCSs were categorized into infertility risk groups.

resultsThe median levels of AMH, AFC and OV were lower in CCSs (1.9 vs. 2.1 ng/ml, 12.0 vs. 13.0, 6.8 vs. 8.0 cm3) compared with controls, although statistically significant only for OV (p = 0.021). AMH levels in CCSs <40 years were lower for those classified as high-risk (p = 0.034) and very high-risk (p<0.001) for infertility, based on the Swedish risk classification. Similarly, AFC was reduced in the high-risk (p<0.001) and the very high-risk groups (p = 0.003). CCSs of all ages showed a trend towards impaired fertility, especially in the very high-risk group. POI was diagnosed in 22/167 CCSs, of whom 14 were in the high- and very high-risk groups. The results according to the PanCareLIFE classification were similar.

conclusionBoth the Swedish and the PanCareLIFE infertility risk classifications are reliable tools for identifying those at risk of reduced ovarian markers and fertility, as well as POI. We recommend fertility preservation counselling for patients receiving highly gonadotoxic treatments (i.e., Cyclophosphamide Equivalent Dose ≥6 g/m2, radiotherapy exposure to ovaries or stem cell transplantation) with follow-up at a young reproductive age due to the risk of a shortened reproductive window.

Indexed as

Anti-Mullerian HormoneInfertility, FemaleNeoplasmsAdultCancer SurvivorsCase-Control StudiesChildCross-Sectional StudiesFemaleFertilityHumansMiddle AgedOvaryPrimary Ovarian InsufficiencySwedenYoung AdultAnti-Mullerian Hormone

Identifiers

PMID39133666
PMCPMC11318921

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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.