Reproductive endocrinology. Hypothalamic–pituitary–ovarian dysfunction after prepubertal chemotherapy and cranial irradiation for acute leukaemia
Source: Human Reproduction, Volume 16, Number 9, September 2001 , pp. 1838-1844(7)
Publisher: Oxford University Press
Abstract:BACKGROUND: We assessed adult hypothalamic–pituitary–ovarian function following treatment with chemotherapy and cranial irradiation for childhood acute lymphoblastic leukaemia. METHODS: The patients (n = 12) had median age at diagnosis of 4.7 years, and at assessment of 20.8 years. They collected a daily urine sample over two to five consecutive menstrual cycles (total of 41 cycles) for analysis of LH and steroid excretion. Blood sampling and ovarian ultrasound examination was performed in the early follicular phase. Sixteen healthy women with regular menstrual cycles were recruited as controls. RESULTS: Urinary LH excretion was significantly lower in patients throughout the cycle, particularly during the LH surge (P < 0.0001). The length of the luteal phase was significantly shorter in patients than in normal controls (12.2 ± 0.3 versus 13.6 ± 0.4 days, P = 0.01) with a high prevalence of short (≤11 days) luteal phases (15/39 cycles). Luteal phase pregnanediol excretion was slightly but not significantly lower. Follicular and luteal phase excretion of oestrone was lower in patients than in controls (P = 0.01). Early follicular phase plasma oestradiol was also lower in the patient group (P = 0.032) although LH, FSH, inhibin A and B concentrations were similar. CONCLUSIONS: These data indicate that treatment for childhood leukaemia results in subtle ovulatory disorder in some patients, probably related to cranial irradiation. Follow-up of these women is required to detect any effect on reproductive potential.
Document Type: Research Article
Affiliations: 1: Section of Child Life and Health, Department of Reproductive and Developmental Sciences, University of Edinburgh, 2: MRC Human Reproductive Sciences Unit, Centre for Reproductive Biology and 3: Section of Obstetrics and Gynaecology, Department of Reproductive and Developmental Sciences, University of Edinburgh, Edinburgh, UK
Publication date: 2001-09-01
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.