PURPOSE Aim of this study is to evaluate the long-term effects of combination chemotherapy treatment for girls with Hodgkin's lymphoma (HL) on gonadal function using anti-Müllerian hormone (AMH) and inhibin B as ovarian reserve parameters.

PATIENTS AND METHODS Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), inhibin B and AMH were measured in 32 women treated from 1974–1998 for pediatric HL with chemotherapy, with the intention to avoid radiotherapy. All patients (median age 25.0 yr (range 19.2–40.4 yr.)) were in complete remission with a median follow-up time of 14.0 yr. (range 5,7–24.5 yr.) after therapy. All patients were treated with combination chemotherapy ABVD or EBVD with or without MOPP. Because of incomplete remission or relapse, involved field radiotherapy was needed in 7/32 women. Results were compared with a healthy control group.

RESULTS Patients treated with 6 or more cycles of MOPP combination chemotherapy had significantly higher levels of FSH and lower serum levels of inhibin B and AMH compared with healthy women (FSH 17.0 U/l vs. 6.0 U/l (p<0.05); inhibin B 23.0 ng/l vs. 112.5 ng/l (p<0.01); AMH 0.39 µg/l vs. 2.10 µg/l (p<0.01)). AMH was also significantly lower compared with women treated without MOPP (median 0.39 µg/l vs. 1.40 µg/l; p=0.01).

CONCLUSIONS Women treated during childhood for HL with MOPP seem to have a distinctly lower ovarian reserve as measured by lower AMH values at early adulthood, compared to healthy women. Moreover, AMH seems to be the only predictor that is sufficiently sensitive to detect this decrease in ovarian reserve.