Dynamics of changes in the main indicators of reproductive health of women receiving chemotherapy for malignant breast tumors

Abstract

Breast cancer is the second most common cancer in the world and the most common cancer among women. The use of chemotherapy as a component of comprehensive treatment leads to the development of chemoinduced premature ovarian failure. The aim of the study was to examine the dynamics of changes in the main indicators of reproductive health of women who received chemotherapy for malignant neoplasms of the breast. Reproductive health of patients (levels of antimullerian hormone, estradiol and follicle-stimulating hormone, ovarian volume and number of antral follicles) before chemotherapy and one, two, and three years after completion of chemotherapy was studied according to the purpose and objectives of the study. The obtained data were processed using the statistical software package SPSS 20.0 for Windows. Quite significant changes in the reproductive health of women in the study group were manifested in the form of menstrual disorders (oligomenorrhea, amenorrhea), involuntary abortions, inability to conceive. Changes in hormonal status were characterized by a progressive decrease in antimullerian hormone and estradiol levels and an increase in follicle-stimulating hormone levels. In addition, there was a decrease in ovarian volume and a decrease in the number of antral follicles. The dynamics of changes in the studied indicators was characterized by a sharp deterioration during the first year after chemotherapy, followed by less rapid progression. This trend is explained by dystrophic changes in ovarian tissue after chemotherapy, and at a later date - in addition, the agerelated involution of the ovaries. The dynamics of changes in the main hormonal and ultrasound parameters of the ovarian reserve indicates significant impairment of reproductive function in women receiving chemotherapy for malignant neoplasms of the breast.