PhD Scientific Days 2025

Pathological and Oncological Sciences I.

Biomarkers of Ovarian Insufficiency in Women Who Survived Childhood Cancer

Name of the presenter

Pesti Sára

Institute/workplace of the presenter

Tűzoltó Street Department of the Pediatric Center of Semmelweis University

Authors

Dr. Sára Pesti¹

1: Tűzoltó Street Department of the Pediatric Center of Semmelweis University

Text of the abstract

Introduction: A serious complication of anticancer treatment in childhood is the high risk of primary ovarian insufficiency. Low serum AMH levels indicate insufficient ovarian function, so it may also be a marker of gonadotoxicity caused by anticancer treatment.
Aims: The aim of our study was to answer the question of whether lower AMH levels can be measured in girls who have survived childhood malignancies in the high-risk group in terms of gonadotoxicity than in the low-risk group, and girls who have undergone autologous stem cell transplantation as part of oncotherapy are more likely to have low AMH levels, and whether a lower AMH level can be measured in the case of elevated FSH.
Methods: The girls with cancer were treated at the Tűzoltó Street Department of the Pediatric Center of Semmelweis University, were examined, and they had completed their anti-cancer treatment at least five years ago. Based on the risk of gonadal dysfunction caused by the received chemotherapy drugs, we divided the girls into low, medium and high risk groups and measured serum AMH, FSH, LH, E2 hormone levels after taking a detailed medical history and physical examination. We used Fisher's exact tests and a logistic regression model for the statistical evaluation of our data.
Results: Low AMH concentrations were measured in 35.71% of the 56 girls included in our study. There was visible tendency regarding lower AMH levels in the higher risk group (OR=10, 757) (95%-os CI [0,975-118,6]), however, we could not detect a significant association (p=0,052), which is presumably due to the small sample size. Low AMH levels were measured in all cases after autologous stem cell transplantation (p=0.000). In case of elevated FSH levels, low AMH levels were measured in all cases, but no significant assosiation could be detected (p=0.051).
Conclusion: Before starting oncotherapy, it is of utmost importance to provide fertility preservation options for girls at high risk of primary ovarian insufficiency caused by the planned treatment. The high gonadotoxicity of the conditioning chemotherapy treatment probably results in low AMH levels after autologous stem cell transplantation. The results show that AMH is a useful early predictor in the study of ovarian failure.
Funding: Kisangyal Gyermekalapítvány.