The Impact of Iodine-131 Internal Radiation Therapy on Ovarian Reserve in Patients with Differentiated Thyroid Cancer Evaluated by Serum AMH
Objective To analyze the serum anti-Müllerian hormone(AMH)levels in female patients with differentiated thyroid cancer(DTC)treated with iodine-131 internal radiation to find out the extent of treatment damage to patients'ovaries and the recovery of ovarian function after treatment.Methods A total of 73 female patients with DTC,who underwent iodine-131 internal radiation therapy for the first time,were selected,with regular menstrual periods and no obvious abnormalities of ovarian function.The serum AMH levels were measured 1 d before the iodine-131 treatment,and 4 d,3 months and 6 months after treatment,among which 14 patients had AMH values below the lower limit of the reference value before treatment and were excluded from the study.59 patients were finally included,3 patients aged 15-20 years,13 patients aged 21-25 years,15 patients aged 26-30 years,14 patients aged 31-35 years,7 patients aged 36-40 years,and 7 patients aged 41-45 years;the decline rate of AMH at various time points after treatment and its correlation with patient age and treatment dose were analyzed in 24 patients who had iodine-131 dose≤100 mCi and 35 patients who had iodine-131 dose＞100 mCi.Results The AMH levels in patients were reduced at 4 d,3 months and 6 months after treatment compared with 1 d before treatment,with an average decrease rate of 2.47%,41.7%and 32.33%,respectively.The decline rate of AMH was not significantly correlated with age(P＞0.05),but was correlated with treatment dose(P＜0.05).There was no statistically significant difference in the decrease rates of AMH 4 d after treatment between different dose groups(P＞0.05);the AMH decline rate at 3 and 6 months after treatment in the treatment dose＞100 mCi group was significantly higher than that in the treatment dose≤100 mCi group(both P＜0.05).The decline rates of AMH in all age groups at 3 months after treatment were higher than those 4 d after treatment;the decline rate of AMH in the 41-45 age group at 6 months after treatment was higher than that at 3 months after treatment,while the decline rates in other age groups were lower than those at 3 months after treatment.Conclusions Iodine-131 internal radiation therapy can lead to a significant decrease in AMH levels,which potentially has an effect on women's ovarian reserve,and the degree of decrease and recovery may be related to the dosage of iodine-131 used.The degree of decline in ovarian reserve caused by iodine-131 therapy varies in patients of different age groups.
differentiated thyroid cancerinternal radiation therapy with iodine-131serum anti-Müllerian hormoneovarian reserve
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