Anti-Müllerian hormone in pre-menopausal females after ablative radioiodine treatment for differentiated thyroid cancer

• Published in: Endocrine Vol. 60; no. 3; pp. 516 - 523
• Main Authors: Giusti, Massimo, Mittica, Miranda, Comite, Paola, Campana, Claudia, Gay, Stefano, Mussap, Michele
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2018; Springer Nature B.V
• Subjects: 17β-Estradiol; Adult; Anti-Mullerian Hormone - blood; Diabetes; Endocrinology; Female; Follicle-stimulating hormone; Health risk assessment; Humanities and Social Sciences; Humans; Infertility; Internal Medicine; Iodine Radioisotopes - therapeutic use; Medicine; Medicine & Public Health; Menstrual Cycle; Menstruation; Middle Aged; multidisciplinary; Original Article; Pregnancy; Pregnancy Rate; Premenopause; Progesterone; Prolactin; Science; Surgery; Thyroid cancer; Thyroid Neoplasms - blood; Thyroid Neoplasms - radiotherapy; Thyroidectomy; Radioactive iodine; Thyroid cancer; Anti-mullerian hormone
• ISSN: 1355-008X; 1559-0100
• DOI: 10.1007/s12020-017-1510-3

Purpose In recent years, anti-Mullerian hormone (AMH) has been considered a reliable index of ovarian reserve. There are few data on AMH values in thyroid cancer. The aim of this study was to evaluate AMH levels in pre-menopausal women with a history of low-risk thyroid cancer. Methods Thirty-four women (aged 40.7 ± 6.7 years) were studied 7.1 ± 0.9 years after surgery and at least one RAI treatment. A group of 23 thyroid cancer women (41.6 ± 7.4 years) who had undergone only thyroidectomy served as controls. AMH, follicle-stimulating hormone (FSH) and estradiol were assayed on days 2–3, and prolactin and progesterone levels on days 21–24 of the menstrual cycle. Results Pregnancy (RAI group 62%; control group 61%) and miscarriage rates (18% and 26%) were similar. AMH levels were similar in the RAI (10.7 ± 1.7 pmol/l) and control (17.5 ± 4.7 pmol/l) groups. Regular menses were reported in 41% and 52% of RAI and control subjects, respectively. Non-ovulatory cycles were noted in 26% and 35% of RAI and control women, respectively. AMH levels were found to be negatively correlated with age (RAI group P  = 0.0003; control group P  = 0.0001) and FSH, and positively correlated with progesterone, but not with the other hormonal parameters. Conclusions AMH should replace FSH in the evaluation of gonadal reserve in pre-menopausal thyroid cancer women. At present, age is the only predictor of AMH levels. About one out of two women with a history of thyroid cancer suffers from menstrual dysregulation, but infertility must be considered a low risk.