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- Title
Self-collected dried blood spots as a tool for measuring ovarian reserve in young female cancer survivors.
- Authors
Roberts, S. C.; Seav, S. M.; McDade, T. W.; Dominick, S. A.; Gorman, J. R.; Whitcomb, B. W.; Su, H. I.
- Abstract
<bold>Study Question: </bold>Are female young cancer survivors (YCS) able to self-collect high-quality dried blood spots (DBSs) at home to provide biospecimens for studying ovarian reserve?<bold>Summary Answer: </bold>YCS can self-collect high-quality DBS specimens in non-clinical settings, and anti-Mullerian hormone (AMH) levels can be assayed in such specimens.<bold>What Is Known Already: </bold>Large-scale biosample collection is a barrier to studying ovarian reserve in YCS. DBS collected by research personnel has high acceptability. AMH levels measured in DBS are highly correlated with those measured by serum-based methods.<bold>Study Design, Size, Duration: </bold>In a prospective cohort study, YCS were recruited to self-collect DBS samples. AMH levels were assayed in 112 samples.<bold>Participants/materials, Setting, Methods: </bold>YCS participants, ages 18-44, were recruited from a nationwide longitudinal cohort and DBS collection materials were posted to them. AMH levels were assayed by the Ansh DBS AMH ELISA and compared according to participant characteristics.<bold>Main Results and the Role Of Chance: </bold>Among 163 potential participants, 123 (75%) were enrolled. Of those enrolled, 112 (91%) were able to complete DBS self-collection and submit mailed samples adequate for measuring AMH. Participants (mean age 31.6 [SD 5.5]) were 85% white, 87% college graduates and 46% reported higher income. Common cancer types were lymphoma and leukemia (34%), breast cancer (30%) and thyroid or skin cancer (8%). The geometric mean (95% confidence interval) AMH level in DBS samples was 0.24 ng/ml (0.16-0.36). In adjusted analysis, AMH levels for survivors of breast cancer (0.02 ng/ml [0.01-0.07]) or leukemia/lymphoma (0.03 ng/ml [0.01-0.08]) were lower than the levels in thyroid or skin cancer survivors (0.12 ng/ml [0.03-0.44]). Pelvic radiation remained associated with lower AMH levels (0.20 ng/ml [0.10-0.40] in unexposed versus 0.02 ng/ml [0.01-0.06] in exposed). Amenorrheic survivors had AMH levels (0.02 ng/ml [0.01-0.06]) that were lower than those of YCS with 7-9 (0.09 ng/ml [0.03-0.32]) or ≥10 (0.17 ng/ml [0.08-0.37]) menstrual periods in the past year.<bold>Limitations, Reasons For Caution: </bold>The results are generalizable to a population of highly educated, higher income YCS. It is unclear how generalizable the results are to other populations.<bold>Wider Implications Of the Findings: </bold>Self-collected DBS is a patient-friendly and minimally invasive tool for studying ovarian reserve in geographically diverse populations.<bold>Study Funding/competing Interests: </bold>Research related to the development of this paper was supported by the National Institutes of Health, grants UL1 RR024926 pilot and HD080952-02, and by the American Cancer Society MRSG-08-110-01-CCE. The authors report no competing interests.
- Subjects
OVARIAN reserve; CANCER patients; DISEASES in women; LEUKEMIA; DIAGNOSTIC specimens
- Publication
Human Reproduction, 2016, Vol 31, Issue 7, p1570
- ISSN
0268-1161
- Publication type
journal article
- DOI
10.1093/humrep/dew114