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Author Notes:

Corresponding author: Lisa Shandley, Department of Gynecology and Obstetrics, Emory University School of Medicine, 550 Peachtree Street NE, Medical Office Tower, 8th floor, Atlanta, GA 30308, Tel: 404-727-8499; fax: 404-727-8737, Lisa.Shandley@emory.edu.

Conflicts of Interest: Nothing to disclose.


Research Funding:

Funding for this research was provided by The Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant 1R01HD066059 and supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers ULITR000454 and TL1TR000456.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Obstetrics & Gynecology
  • Reproductive Biology
  • Cancer
  • infertility
  • ovarian reserve
  • polycystic ovary syndrome
  • AMH

Impact of cancer treatment on risk of infertility and diminished ovarian reserve in women with polycystic ovary syndrome


Journal Title:

Fertility and Sterility


Volume 109, Number 3


, Pages 516-+

Type of Work:

Article | Post-print: After Peer Review


Objective: To compare markers of fertility and ovarian reserve between cancer survivors and cancer-free women with and without polycystic ovary syndrome (PCOS). Design: Furthering Understanding of Cancer, Health, and Survivorship in Adult (FUCHSIA) Women's Study—a population-based cohort study. Setting: Not applicable. Patient(s): Female cancer survivors (n = 1,090) aged 22–45 years, diagnosed between ages 20 and 35 years, and at least 2 years after diagnosis; 369 participated in a clinic visit. Three hundred seventy-four reproductive-aged women without cancer also completed a clinic visit. Intervention(s): None. Main Outcome Measure(s): Infertility, time to first pregnancy after cancer diagnosis, and measures of ovarian reserve (antimüllerian hormone [AMH] and antral follicle count [AFC]). Results: Seventy-eight cancer survivors (7.2%) reported a PCOS diagnosis, with 41 receiving gonadotoxic treatment. Survivors with PCOS exposed to gonadotoxic treatment (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.2–4.5) and unexposed (OR 3.4, 95% CI 1.7–6.9) were more likely to report infertility than unexposed survivors without PCOS and were more likely to have fewer children than desired (exposed: OR 2.1, 95% CI 1.0–4.2; unexposed: OR 3.0, 95% CI 1.4–6.8). After adjusting for age, comparison women with PCOS had the highest markers of ovarian reserve (AMH: 2.43 ng/mL, 95% CI 1.22–4.82 ng/mL; AFC: 20.7, 95% CI 15.3–27.8), and cancer survivors without PCOS treated with gonadotoxic agents had the lowest levels (AMH: 0.19 ng/mL, 95% CI 0.14–0.26 ng/mL; AFC: 7.4, 95% CI 6.4–8.5). Conclusion(s): Despite having higher AMH and AFC on average after cancer treatment, cancer survivors with PCOS were less likely to meet their reproductive goals compared with survivors without PCOS.

Copyright information:

© 2017 American Society for Reproductive Medicine

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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