Effect of chemotherapy on ovarian function in pre-menopausal women with breast cancer.
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Chemotherapy has been known to negatively affect ovarian function. This sometimes results in infertility, particularly in young patients who still desire to have children. The effect of chemotherapy on young women with breast cancer has not been extensively studied. The objective of the present study was to determine the effects of chemotherapy on ovarian function/reserve among pre-menopausal female patients with breast cancer. Pre-menopausal females with breast cancer scheduled for chemotherapy were recruited for the study. Blood samples were obtained to determine the plasma concentrations of three hormones, namely estrogen, follicle stimulating hormone and anti-Müllerian hormone. The samples were collected at pre-chemotherapy, at 3 months and then at 6 months post-chemotherapy. The assays were performed using the direct immunoenzymatic colorimetric method. Data from 82 participants were analyzed. The age range of the patients was 32-41 years (mean age, 36.6±4.6 years). There were significant reductions in the plasma concentrations of estrogen and anti-Müllerian hormone, with significant increase in the levels of follicle stimulating hormone. An irregular or the cessation of menstrual flow was observed in some patients who were >30 years of age. There was no significant difference in the effects with different chemotherapeutic regimens for breast cancer. The negative ovarian effects on tested hormones persisted 6 months post-chemotherapy. Overall, the present study demonstrates that chemotherapy for breast cancer has deleterious effects on ovarian function, as reflected by altered plasma levels of estrogen, follicle stimulating hormone and anti-Müllerian hormone. Clinicians should be aware of this and counsel such patients appropriately on fertility issues to ensure a better quality of life for patients who survive breast cancer.