Singh, K.J.D.L.; (2008) Ovarian reserve testing in premenopausal recipients of chemotherapy for breast cancer. Doctoral thesis , University of London.

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Abstract

The incidence of breast cancer has progressively increased, while survival rates have simultaneously improved. Young women with breast cancer are likely to suffer ovarian damage from chemotherapy, which can have a profound effect on their quality of life. At present, it is impossible to predict the functional lifespan of the chemotherapeutically damaged ovary as there is insufficient data. Ovarian reserve tests (ORT) have the potential to estimate the reproductive age of the ovaries, which would allow an accurate estimation of fertility status and the risk of premature ovarian failure. This project investigates the use of ORT in young women with breast cancer. To achieve this, biochemical and biophysical ORT were performed in a mixed longitudinal and cross-sectional study group comprising young women treated with chemotherapy for breast cancer and age-matched, regularly menstruating controls with proven fertility. Overall the results indicate potential for the use of inhibin B, anti-mullerian hormone, oestradiol and antral follicle count in the evaluation of these patients. An in vitro study was performed to supplement the clinical study, in which the effects of cytotoxic agents commonly used to treat breast cancer were examined by simultaneously applying equivalent doses of each to a breast cancer cell line and primary granulosa-luteal cell cultures respectively. The effects of these agents were measured in terms of cellular integrity (apoptosis) and functionality (hormones). Overall the results suggest variations in cytotoxicity (LD50) between breast and granulosa cells which have potential therapeutic implications.

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