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EV315/#850  Assessing fertility potential and fertilty awareness in young women with ovarian malignancies
  1. Shalini Rajaram1,
  2. Dipendra Sharma2,
  3. Lakhwinder Singh1,
  4. Jaya Chaturvedi2,
  5. Anupama Bahadur2,
  6. Ajeet Bhadoria3,
  7. Latika Chawla2,
  8. Rajlaxmi Mundhra2,
  9. Amrita Gaurav2,
  10. Kavita Khoiwal1,
  11. Amit Sehrawat4 and
  12. Deepak Sundriyal4
  1. 1All India Institute of Medical Sciences, Rishikesh, Obstetrics and Gynecology (Gynecologic Oncology), Rishikesh, India
  2. 2All India Institute of Medical Sciences, Rishikesh, Obstetrics and Gynecology, Rishikesh, India
  3. 3All India Institute of Medical Sciences, Rishikesh, Community and Family Medicine, Rishikesh, India
  4. 4All India Institute of Medical Sciences, Rishikesh, Medical Oncology, Rishikesh, India

Abstract

Introduction This study aimed to evaluate fertility potential and awareness in young women with ovarian malignancy.

Methods Women aged ≤40 years with ovarian malignancy entered this exploratory study done over a 12 months. Calculation of sample size was not possible as literature showed no previous data on serum AMH & antral follicle count (AFC). Before treatment 6-point fertility awareness questionnaire was administered. Pre and post treatment serum AMH levels, and antral follicle count (AFC) was measured. Baseline parameters were compared to a cohort of normal young Indian women.

Results Women (n=22) with median age of 21 years (13-30 years) were recruited. Majority of women (n=16 72.6%) had germ cell tumours. Effects of ovarian cancer and treatment on fertility were known to majority (n=21, 95.5%). 72.7% (n=16) were unaware of advanced fertility preservation options. 54.5% (n=12) underwent upfront surgery while 45.5% (n=10) received NACT followed by fertility sparing surgery. The median value of pre-treatment AMH and AFC were 1.82 (IQR 0.45-3.71) ng/ml and 6 (IQR 4-8) respectively compared to post-treatment decline in values to 1.10 (0.25-2.38) ng/ml and 5 (4-6) respectively, (p=0.001 and 0.004). Pre-treatment values in study cohort were significantly lower vis-à-vis age-matched healthy controls with median AMH and AFC of 3.48 (1.12-8.21) and 18 (8-32) respectively (p<0.001).

Conclusion/Implications Fertility potential declined post therapy in young women undergoing ovarian cancer treatment. Ovarian malignancy showed decreased fertility markers when compared to age-matched controls. However, larger studies are needed to confirm this effect. Fertility counselling should become an integral part of management in young women.

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