Table 3.
Ovarian Reserve Data Extracted by Study (cont.)
| Study Details | Age, y | na | Cancer | Treatment | Method | Results | MMAT (%) |
|---|---|---|---|---|---|---|---|
| Thomas-Teinturier et al,36 2015 (France) | Median age at diagnosis, 9.3 (range, 0.04–17.7); median age at study, 25 (range, 17–40) | 105 | 61% solid tumors; 39% hematologic | 100% alkylating agents; 18% subdiaphragmatic RT | Hormone measurement Transvaginal ultrasound |
Survivors had lower OSA (3.5 vs 4.4 cm2; P=.0004) and AMH levels (10.7 vs 22 pmol/L; P=.003) vs controls, but AFC was not different (12 vs 11; P=.8) OSA, AMH, and AFC were lower in patients who received high-dose vs conventional-dose alkylating agents (P=.01 for OSA; P=.002 for AMH; P<.00001 for AFC) HL survivors had the greatest reduction in ovarian parameters, and procarbazine (not cyclophosphamide or ifosfamide) dose was associated with reduced OSA, AFC, and AMH, and higher FSH; however, the individual impacts of procarbazine and HL on ovarian reserve could not be dissociated AFC was correlated with AMH and, to a lesser extent, OSA |
100 |
| Salih etal.24 2015 (US) | Median age at diagnosis, 7 (range, 0–20); age at last follow-up, 14.0 (range, 2–34) | 222 | Various (25% ALL) | Chemo. RT. BMT. or combination 74% chemo; 23% RT; 7% BMT | Hormone measurement | 69% had normal ovarian reserve (FSH <10 IU/L), 17% had DOR (FSH. 10–40 IU/L) 14% had POI (FSH >40 IU/L) |
75 |
Abbreviations: AFC, antral follicle count; ALL, acute lymphoblastic leukemia; AMH, anti-Mullerian hormone, BMT, bone marrow transplant; CED, cyclophosphamide equivalent dose; chemo, chemotherapy; COCPs, combined oral contraceptive pills; DOR. diminished ovarian reserve; FSH, follicle-stimulating hormone; HL, Hodgkin lymphoma; MMAT, Mixed Methods Appraisal Tool; MOPP, mechlorethamine/vincristine/procarbazine/prednisone; OCPs, oral contraceptive pills; OSA, ovarian surface area; POI, primary ovarian insufficiency; RT, radiotherapy; TBI, total body irradiation.
The number of patients reflects only the female cancer survivors in each study; some of these studies included male survivors and/or healthy controls, but these numbers are not reflected.