Main conclusion
Very low AMH during chemotherapy does not always mean permanent loss of ovarian function. In a small real-world cohort treated for high-risk GTN, AMH partially recovered over subsequent months, and some patients later achieved live birth.
What the study did
The retrospective cohort included 68 patients receiving multiagent EMA/CO or FAEV. Median AMH was 2.73 ng/mL before treatment, 0.04 during treatment, 0.47 one month afterward, and 1.26 at six months. AMH recovered to at least 1.0 ng/mL in 50 of 68 women, or 73.5%. Among 28 uterus-preserving patients actively attempting pregnancy, 20 achieved at least one live birth.
Key limitations
The cohort was small and retrospective and included different regimens. Women attempting pregnancy were a highly selected subgroup. AMH reflects a quantitative aspect of ovarian reserve, not oocyte quality or a guarantee of pregnancy. Differences between EMA/CO and FAEV do not prove regimen superiority without randomization.
What can be said to patients
A single AMH result during chemotherapy should not be treated as a final verdict. Oncofertility counseling should consider time since treatment, age, regimen, menstrual function, ovarian imaging, and the patient’s plans.
Source
International Journal of Gynecology and Obstetrics, 2026. DOI: https://doi.org/10.1002/ijgo.71318
PubMed: https://pubmed.ncbi.nlm.nih.gov/42687833/
Educational material; it does not replace individual medical advice.