Reproductive function of patients with lymphoproliferative diseases after completion of chemotherapy
- Authors: Biryukova A.M.1, Antukh I.E.1, Nazarenko T.A.1, Khokhlova S.V.1, Martirosyan Y.O.1, Tumyan G.S.2, Shpirko V.O.2
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Affiliations:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation
- Issue: No 7 (2023)
- Pages: 66-73
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/568719
- DOI: https://doi.org/10.18565/aig.2023.79
- ID: 568719
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Abstract
Objective: The objective of this study was to investigate the state of ovarian reserve in patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma after completion of polychemotherapy (PCT). The study also aimed to identify factors influencing the recovery or loss of reproductive function and determine the long-term prospects for reproductive function.
Materials and methods: The study included 247 women with lymphoproliferative diseases, including Hodgkin's lymphoma and non-Hodgkin's lymphoma. The patients were divided into two groups: group I (n=194), consisting of those who returned to their menstrual cycle after treatment completion, and group II (n=53), consisting of those diagnosed with premature ovarian failure. Anamnestic, clinical, and reproductive characteristics of the patients were assessed. The state of the ovarian reserve was compared in terms of AMH, FSH concentrations and antral follicle count in the ovaries before and after PCT. These parameters were compared between the groups of patients who did and did not have their menstrual cycles restored after treatment completion.
Results: Among patients with Hodgkin's lymphoma, the frequency of menstrual cycle recovery and loss of ovarian function was 79.68% and 20.32%, respectively. In patients with non-Hodgkin's lymphoma, the frequencies were 75% and 25%, respectively. Restoration of the menstrual cycle occurred on average 3 months after completion of chemotherapy in both types of lymphoproliferative diseases. One hundred forty-nine (60.32%) women who planned a pregnancy became pregnant, and 46.56% (115) gave birth to healthy children. Predictive factors for the restoration of the menstrual cycle after treatment completion were the woman's age being less than 28.5 years and AMH levels above 2.45 ng/ml. PCT had a negative effect on ovarian function, with the ovarian reserve indicators decreasing twofold compared to the initial values. This decrease predicted premature depletion of ovarian function within 2.5–10 years, depending on the initial parameters of the ovarian reserve.
Conclusion: It is important to determine the baseline ovarian reserve in young women with lymphoma when planning PCT to predict the recovery or loss of reproductive function after treatment completion. For patients with initially reduced ovarian reserve and women receiving high-dose PCT, preliminary collection and cryopreservation of oocytes/embryos are advisable due to the high risk of a sharp decline and loss of ovarian function.
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About the authors
Almina M. Biryukova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Author for correspondence.
Email: a_birukova@oparina4.ru
PhD, deputy chief accountant for clinical work at the Scientific Clinical Center of ART named after Frederik Paulsen
Russian Federation, 117997, Moscow, Akademika Oparina str., 4Irina E. Antukh
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: nika06@inbox.ru
postgraduate student at the Scientific Clinical Center of ART named after Frederik Paulsen
Russian Federation, 117997, Moscow, Akademika Oparina str., 4Tatiana A. Nazarenko
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: t_nazarenko@oparina4.ru
Dr. Med. Sci., Рrofessor, Head of the Department at the Scientific Clinical Center of ART named after Frederik Paulsen, Director of the Institute of Reproductive Medicine
Russian Federation, 117997, Moscow, Akademika Oparina str., 4Svetlana V. Khokhlova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: s_hohlova@oparina4.ru
Dr. Med. Sci., Head of the Department of Anticancer Drug Therapy
Russian Federation, 117997, Moscow, Akademika Oparina str., 4Yana O. Martirosyan
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Email: ya_martirosyan@oparina4.ru
PhD, Researcher at the Scientific Clinical Center of ART named after Frederik Paulsen
Russian Federation, 117997, Moscow, Akademika Oparina str., 4Gayane S. Tumyan
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation
Email: a_birukova@oparina4.ru
Dr. Med. Sci., Head of the Chemotherapy Department for Hematologic Malignancies
Russian Federation, 115522, Moscow, Kashirskoye Shosse, 24Valeria O. Shpirko
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of the Russian Federation
Email: a_birukova@oparina4.ru
Oncologist at the Chemotherapy Department for Hematologic Malignancies
Russian Federation, 115522, Moscow, Kashirskoye Shosse, 24References
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