Anti-Mullerian hormone and antral follicle count as predictors for embryo/oocyte cryopreservation cycle outcomes in breast cancer patients stimulated with letrozole and follicle stimulating hormone

  • Sanghoon Lee
  • Sinan Ozkavukcu
  • Elke Heytens
  • Fred Moy
  • Rose M. Alappat
  • Kutluk Oktay
Fertility Preservation



To predict embryo/oocyte cryopreservation cycle (ECC) outcomes in breast cancer patients stimulated with letrozole and follicle stimulating hormone for fertility preservation based on observed anti-mullerian hormone (AMH) levels and antral follicle counts (AFC).


The correlation between AMH and AFC and ECC outcomes were analyzed retrospectively on forty one women with breast cancer before adjuvant treatment.


AMH and AFC had a stronger correlation with the total number of oocytes and the number of mature oocytes than age, FSH, and inhibin B. Subjects were evaluated by the number of mature oocytes retrieved to create cutoff points of AMH level, which identified 1.2 ng/mL as a potential value. Seven of 18 patients with AMH levels ≤1.2 ng/mL had low response versus none of 23 with >1.2 ng/mL, (p = 0.001).


AMH is the most reliable serum marker of ECC outcomes, together with AFC as a biophysical marker, in breast cancer patients. Low response is highly likely when the AMH level is ≤1.2 ng/mL.


Anti-Mullerian hormone (AMH) Letrozole Breast cancer Fertility preservation Cryopreservation 



This study is partially supported by NIH HD 053112.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Sanghoon Lee
    • 1
  • Sinan Ozkavukcu
    • 1
  • Elke Heytens
    • 1
  • Fred Moy
    • 2
  • Rose M. Alappat
    • 1
  • Kutluk Oktay
    • 1
  1. 1.Institute for Fertility Preservation and Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics and GynecologyNew York Medical CollegeValhallaUSA
  2. 2.Biometrics, Data Management and PK/PD Unit, Graduate School of Basic Medical Sciences, Department of PathologyNew York Medical CollegeValhallaUSA

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