Toward a better follow-up of ovarian recovery in young women after chemotherapy with a hypersensitive antimullerian hormone assay

Objective: To evaluate the utility of a hypersensitive assay for measuring low antimullerian hormone (AMH) levels in young cancer patients during the ovarian recovery phase of their chemotherapy. Design: Retrospective study. Setting: Academic medical center. Patient(s): Fifty-eight samples drawn at least 3 months after the end of chemotherapy in 30 women having either breast cancer (n = 13) or hematologic malignancies (n = 17) were selected to constitute two equally size groups: amenorrhea (n = 30 samples) or spontaneous cycle (n 28 samples). Intervention(s): None. Main Outcome Measure(s): Serum AMH levels were measured by a conventional AMH ELISA (EIA AMH/MIS) and a hypersensitive ELISA (PicoAMH, AnshLabs) on the same sample. Result(s): Using a conventional assay, serum AMH was detectable (>= pmol/L) in 6.7% and in 10.7% of the samples corresponding to amenorrheic or cycling patients, respectively (nonsignificant). By contrast, with PicoAMH, serum AMH was detectable (>= 0.07 pmol/L) in 71.4% of the samples from cycling women vs. 16.7% of the samples from amenorrheic patients. Multivariate regression analysis showed that among putative contributors, only the menstrual status (r = 0.307) and serum FSH level (r = -0.546) were independently correlated to a detectable serum AMH with the picoAMH assay exclusively. Conclusion(s): The picoAMH assay, allowing measurement of very low AMH concentrations in human serum, should refine postchemotherapy ovarian follow-up in young women. (C) 2014 by American Society for Reproductive Medicine.