1. ¹Department of Obstetrics and Gynaecology, Royal Free and University College London Medical School, 86-96 Chenies Mews, London WC1E 6HX, UK
2. ²Department of Oncology, Royal Free and University College London Medical School, 91 Riding House Street, London W1W 7BS, UK
3. ³Centre for Proteins and Peptides, School of Biological and Molecular Sciences, Oxford Brookes University, Headington, Oxford OX3 0BP, UK

Correspondence: Dr K Lutchman Singh, E-mail: k.lutchman-singh@ucl.ac.uk

Received 23 March 2007; Accepted 26 April 2007; Published online 29 May 2007.

Abstract

Ovarian reserve can be diminished following treatment for breast cancer. This study evaluated biochemical and biophysical parameters of ovarian reserve in these patients. Biochemical and biophysical tests of ovarian reserve were performed simultaneously in young (age 22–42 years), regularly menstruating women with breast cancer (n=22) and age-matched controls (n=24). All tests were performed before (baseline) and after transient ovarian stimulation in the early follicular phase. Patients were recruited both before and after completion of chemotherapy, with some patients being followed up prospectively. Serum samples were analysed for follicle-stimulating hormone (FSH), luteinising hormone (LH), oestradiol (E₂), inhibins A and B, and antimullerian hormone (AMH). Biophysical (ultrasound) tests included ovarian volume, antral follicle count (AFC), ovarian stromal blood flow and uterine dimensions. Significant differences were revealed (when compared with the controls) for basal FSH (11.321.48 vs 6.620.42 mIU ml^-1, P<0.001), basal AMH (0.950.34 vs 7.891.62 ng ml^-1, P<0.001) and basal inhibin B (19.244.56 vs 83.6113.45 pg ml^-1, P<0.001). Following transient ovarian stimulation, there were significant differences in the increment change () for inhibin B (3.022.3 vs 96.8216.38 pg ml^-1, P<0.001) and E₂ (107.823.95 vs 283.240.34 pg ml^-1, P<0.01). AFC was the only biophysical parameter that was significantly different between patients and the controls (7.800.85 vs 16.771.11, P<0.001). Basal and stimulated biochemical (serum AMH, FSH, inhibin B and E₂) and biophysical (AFC) tests may be potential markers of ovarian reserve in young women with breast cancer.