Abstract
1538
Background: The aim of this study was to prospectively assess the effect of radioiodine therapy (RAIT) for the patients with differentiated thyroid cancer (DTC). Materials and Methods: 81 pre-menopausal women (34.1±6.8 years, range 20-47 years) diagnosed with DTC planning to receive RAIT were recruited for this study, of which 8 subjects underwent the twice RAIT. Serum FSH, LH, estradiol, progesterone, TSH and anti-Müllerian hormone (AMH) levels during the early follicular phase were measured before and 1, 2, 3, 6, 9 and 12 months after RAI therapy (M0, M1, M2, M3, M6, M9, M12).
Results: 76 of 81 subjects followed up after the RAIT and the number of subjects completing follow-up at M0, M1, M2, M3, M6, M9, M12 was 69, 60, 61, 40, 25 and 16, respectively. ① The mean AMH levels were 2.65±2.15, 1.63±1.39, 1.56±1.48, 1.91±1.82, 2.28±1.89, 2.35±2.24 and 2.46±2.40 ng/mL respectively at M0, M1, M2, M3, M6, M9, M12. The AMH level at M2 was significantly lower than that at M0 (P = 0.019), while no significant difference was found among other time points (P > 0.05). ② The descent rates of AMH level based on M0 were 49.0%, 46.0%, 42.0%, 33.1%, 36.0% and 25.4% at M1, M2, M3, M6, M9, M12, respectively. The number at M1 was significantly higher than that at M6, M9 and M12 (P=0.003, P=0.038 and P=0.002) and the number at M12 was significantly lower than that at M1, M2 and M3 (P=0.002, P=0.008 and P=0.034). ③ The AMH levels after the second 131I therapy were lower than that after the first RAIT at M0, M1, M2, M3, M6, and the descent rates after the second RAIT were higher than that after the first RAIT at M1, M2, M3, M6 (P > 0.05), but no statistically significant relation was found between the two treatment. ④ The difference in FSH, LH, estradiol and P levels among all time points was found to be insignificant (P > 0.05). However, there was a trend found in the FSH levels that increased to the peak at M2, but then decreased to the nadir at M12.
Conclusions: This study prospectively showed that the ovarian reserve declined rapidly at M2, with gradual recovery subsequently. The effect of therapy times on ovarian function and variation trend of other female hormones need further exploration. Key Words: Differentiated thyroid cancer, Anti-Müllerian hormone, Ovarian function