A highly-sensitive anti-Müllerian hormone assay improves analysis of ovarian function following chemotherapy for early breast cancer

Joyce Chai, A Forbes Howie, David A Cameron, Richard A Anderson

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

AIM: Anti-Müllerian hormone (AMH) shows promise as a biomarker of the ovarian reserve but current assays are insufficiently sensitive to allow assessment of this post-chemotherapy in most women. We have assessed a new highly sensitive AMH assay (Ansh picoAMH) in the evaluation of ovarian activity in women with very low ovarian reserve after chemotherapy.

METHODS: A prospective cohort and an independent validation cohort of premenopausal women with early breast cancer (eBC) were recruited at the time of diagnosis (combined n=98), and ovarian reserve markers 2-5years later following chemotherapy were assessed in relation to menstrual activity.

RESULTS: The picoAMH assay had a limit of detection of 7.5pg/ml. AMH clearly distinguished women with ongoing menses from those with amenorrhoea at 2years after diagnosis (mean 522±169 versus 8.9±1.3pg/ml, P<0.0001) with high predictive value for continuing menses or amenorrhoea for the subsequent 3years. AMH was detectable in more women than using a previous assay (P=0.004). Other markers of the ovarian reserve (follicle-stimulating hormone (FSH), inhibin B) were also of discriminatory value but to lesser extents. This finding was validated in a second, independent cohort of women treated for eBC.

CONCLUSION: The 10-fold increased assay sensitivity showed very clear distinction between groups based on ovarian activity with excellent prediction of future menses or amenorrhoea. This will improve assessment of post-chemotherapy ovarian function in women and may aid treatment decisions.

Original languageEnglish
Pages (from-to)2367-2374
Number of pages8
JournalEuropean Journal of Cancer
Volume50
Issue number14
DOIs
Publication statusPublished - Sept 2014

Keywords / Materials (for Non-textual outputs)

  • AMH
  • Breast cancer
  • Ovarian function
  • Chemotherapy
  • Ovarian reserve

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