Safeguarding fertility: pioneering study investigates key hormone for women with cancer choosing fertility preservation

Newly diagnosed female cancer patients of reproductive age have a very short window for storing their eggs and embryos before starting cancer treatment. This is a process known as fertility preservation (FP), which protects patients’ ability to have children in the future after completing cancer treatment. Currently, scientists cannot predict which women will be successful in achieving a pregnancy or a healthy live birth after completing chemotherapy and undergoing FP.

In a recent study led by Cancer Center at Illinois (CCIL) member Hillary Klonoff-Cohen, with co-authors Mounika Polavarapu from the University of Toledo and Neha Ramachandran from the Mayo Clinic Evidence-Based Practice Research Program, researchers identified Anti-Mullerian Hormone (AMH) levels as a prognostic indicator for success rates in fertility treatments. AMH is made in the ovaries and shows how many immature eggs a woman still has. This systematic review revealed that baseline AMH levels ranging from 2.1 to 2.8 ng/ml corresponded to 35-42% of live birth rates. The team examined AMH before, during, and after chemotherapy in an attempt to predict which cancer patients would deliver healthy babies.

“The goal of this study was to find out if we could identify certain substances in the blood of young women with cancer that might help predict their chances of having a healthy baby after cancer treatment,” said Klonoff-Cohen.

One of the challenges the team encountered was the variability in follow-up intervals for cancer survivors, making it difficult to consistently assess long-term reproductive outcomes. The time frame ranged substantially between one and 36 months following chemotherapy. Another challenge with this systematic review was the limited availability of data. With the study of AMH levels being a new field, there were very few referential studies accessible to inform the analysis.

This research holds important implications for the quality of life for patients with cancer. Apart from the fundamental goal of wanting to survive and remain cancer-free, fulfilling the desire to start a family can be a crucial milestone after completing treatment. Natural reproduction is an option for becoming pregnant after chemotherapy; however, only 40-60% of women are successful when choosing this approach.

“The next steps for this research include performing studies that identify optimal AMH levels in conjunction with female cancer patients’ age, type of cancer, and treatment regimens. Additionally, it will be essential to standardize AMH measurement techniques, coordinate timing of assessments, focus on similar cancer types, and separate natural and assisted reproductive outcomes,” said Klonoff-Cohen.

The team recognizes and thanks the University of Illinois College of Applied Health Sciences, Community Health, Dean Gallagher, and Dean Hanley-Maxwell for providing the funds for this systematic review.

Editor’s Notes: 

Hillary Klonoff-Cohen is a Professor Emerita of Applied Health Sciences. Klonoff-Cohen is also an affiliate of the University of Illinois Department of Kinesiology and Community Health. She can be reached at klonoffc@illinois.edu.

This research is reported in the paper “Anti-Mullerian Hormone and conception timing as predictors of live births in cancer patients using fertility preservation: a systematic review” and is available online.

https://doi.org/10.3389/fonc.2025.1683794

This article was written by Florence Lin, CCIL Communications Intern.