Reproductive function assessment after surgery plus chemotherapy for germ cell ovarian tumors (MOGCT): novel clues deriving from the field of fertility preservation. (November 2014)

• Record Type: Journal Article
• Authors: Ottolina, Jessica; Mangili, Giorgia; Sigismondi, Cristina; Vanni, Valeria Stella; Viganò, Paola; Candiani, Massimo
• Is Part Of: Gynecological endocrinology. Volume 30:Number 11(2014:Nov.)
• Page Start: 778
• Page End: 780
• Publication Date: 2014-11
• Subjects: Endocrine gynecology -- Periodicals; Generative organs, Female -- Diseases -- Periodicals; 618.1
• DOI: 10.3109/09513590.2014.943724
• Languages: English
• ISSNs: 0951-3590

Abstract

<abstract> <title>Abstract</title> <p>Germ cell ovarian tumors (malignant ovarian germ cell tumors – MOGCT) affect young women and are treated by surgery plus chemotherapy. It is well known that cytotoxic treatment may accelerate depletion of the primordial follicle pool leading to impaired fertility and premature menopause. Aim of this study is to identify patient candidates for fertility preservation strategies. We report our experience in preservation of fertility for four patients affected by MOGCT, referred to San Raffaele Hospital Oncofertility Unit. All patients received fertility sparing surgery plus platinum-based chemotherapy. Two patients were affected by mixed germ cell tumors and two by disgerminomas. After 24 months from the end of treatment, serum AMH levels have been measured. We report lower serum anti-Mullerian hormone (AMH) levels in our patients than in healthy general population as serum AMH levels were under the 25th age-specific percentiles. Fertility preservation, in terms of oocytes cryopreservation, was offered to those two patients with serum AMH levels predictive of significantly poor ovarian reserve (1st and 2nd patients). Using the gonadotropin releasing hormone (GnRH) antagonist protocol for ovarian stimulation, we obtained two and six oocytes, respectively.</p> <p>Therefore, serum AMH, as a marker of ovarian function, can improve the identification of patients that need to be referred to fertility preservation strategies.</p> </abstract>