Article Text
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.