# Does the Type of Cancer Influence Anti-Müllerian Hormone Levels in Women of Reproductive Age? A Cross-Sectional Study

## TL;DR

This study found that women with non-Hodgkin or Hodgkin lymphoma had lower anti-Müllerian hormone levels before cancer treatment compared to those without cancer.

## Contribution

The study provides new evidence that lymphoma may reduce ovarian reserve before therapy, unlike breast cancer.

## Key findings

- AMH levels in breast cancer patients were not significantly different from non-cancer patients.
- Non-Hodgkin or Hodgkin lymphoma patients had significantly lower AMH levels compared to non-cancer patients.
- The AMH reduction in lymphoma patients may be due to systemic effects of the disease.

## Abstract

Background: Cancer treatments can damage the ovaries, with implications for fertility and reproductive lifespan. Therefore, a useful biomarker for fertility preservation counseling is needed, and anti-Müllerian hormone (AMH) measurement provides an index of the treatment gonadotoxicity. The debate is currently open as to whether the ovarian reserve may already be reduced before exposure to anticancer therapy. Therefore, our aim was to evaluate the influence of cancer on AMH levels. Methods: The present retrospective, cross-sectional study was carried out at the Centre for Reproductive Medicine and IVF Unit in Conversano, ASL Bari (Bari, Italy). All data were collected between 2019 and 2023. The serum AMH levels of 175 female patients with cancer were compared with those of non-cancer patients of reproductive age, just before starting chemotherapy. Results: AMH levels in women with breast cancer did not differ significantly from those in women without breast cancer (2.83 [0.81–9.15] ng/mL vs. 2.58 [0.7–9.2] ng/mL; p-value = 0.23). The AMH levels of the non-Hodgkin or Hodgkin lymphoma group were significantly lower than those of the non-cancer group (1.9 [0.7–7.0] vs. 3.2 [0.9–10.00] ng/mL; p-value < 0.05). Conclusions: AMH levels of non-Hodgkin or Hodgkin lymphoma patients were already reduced before cancer therapy compared to those of non-cancer patients. These results may be related to the systemic effect of the lymphoma, compared with other types of cancer.