Abstract P2-12-05: Predictive value of serum anti-Mullerian hormone (AMH) in the outcome of emergency fertility preservation treatments indicated by breast cancer
Authors: Rodriguez-Wallberg KA , Wikander I 
Published: March 2017

Purpose:

Fertility preservation procedures aim at offering young cancer patients an opportunity to build their future families and have biologically-related children. Optimization of fertility preservation options is needed to maximize the chances to success, as the procedures are usually performed as an emergency and they cannot be repeated in most of the patients.

We aimed at investigate the predictive value of serum concentrations of Anti-Mullerian Hormone (AMH) in the outcome of emergency controlled hormonal stimulation (COS) treatments aimed at fertility preservation in women with breast cancer.

Patients and methods:

Prospective cohort study. Patients with breast cancer of reproductive age were included in the study at time of counseling for emergency fertility preservation indicated by planned chemotherapy between January 2012 and May 2016. All fertility preservation treatments were performed at the Reproductive Medicine Clinic of Karolinska University Hospital. The study cohort included 124 women with breast cancer that underwent COS cycles using an antagonist protocol either with or without letrozole supplementation, depending on their tumor estrogen receptor status. Blood draws for estimation of serum AMH concentrations were sampled previously to breast cancer treatment initiation and immediately before performance of fertility preservation.

Main Outcome measures:

The main outcome was the association of baseline serum AMH concentration, crude and age-adjusted, with the number of obtained and cryopreserved oocytes or embryos during the subsequent fertility preservation treatment.

Results

Our preliminary analyses indicate that AMH levels estimated previously to a fertility preservation treatment in women with breast cancer might be a reliable predictor of the outcome of fertility preservation in some age subgroups. The association of AMH levels with fertility preservation outcomes did lack significance in the women that were youngest at time of breast cancer diagnosis, indicating that novel biomarkers are needed in this particular patient group to optimize their fertility preservation treatments. Additionally, women that were on oral contraceptives previously to their breast cancer diagnosis presented with unusually low AMH levels for their age, which also did not correspond to their response to fertility preservation. A logistic regression analysis of the outcome including the chosen variables will follow.

Conclusion

The predictive value of AMH concentration before COS in emergency fertility preservation for women with breast cancer is still debatable. Measurements of AMH concentrations to evaluate ovarian reserve previously to fertility preservation might not correlate with the outcome in all patients with breast cancer and novel biomarkers should be investigated.

Citation Format: Rodriguez-Wallberg KA, Wikander I. Predictive value of serum anti-Mullerian hormone (AMH) in the outcome of emergency fertility preservation treatments indicated by breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-12-05.