Ultrasound Assessment of Ovarian Function Following Radiation Therapy

Ovarian function is important to measure in patients receiving cancer treatments that desire future fertility. Patients with cervical cancer, which affects women of child-bearing age, may be interested in how receiving treatment for the cervical cancer will affect their fertility. Depending on the type and stage of the cancer, women have different options on how to treat the cancer, including radiation, surgery, and chemotherapy. When indicated, radiation therapy carries the risk of ovarian failure in patients wishing to preserve fertility. Ovarian function is measured using hormonal markers and ultrasound markers. Hormonal markers include follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, inhibin and anti-Müllerian hormone (AMH). It has been shown that in ovarian failure following radiation FSH and LH levels are increased; estradiol is increased; inhibin B is decreased; AMH is decreased. Ultrasound markers using color Doppler and 3D ultrasound include the resistance index (RI), pulsatility index (PI), vascularization index (VI), flow index (FI), vascularization flow index (VFI) as well as measurements of antral follicle size and count. New developments in ultrasound technology allow us to more reliably than ever assess ovarian function while undergoing radiation treatment.