Decreased ovarian function is associated with obesity in very long-term female survivors of childhood cancer

Objective: Obesity and gonadal dysfunction are known major side effects of treatment in adult childhood cancer survivors (CCS). In the general population, obesity has a negative influence on female fertility.We aimed to evaluate whether obesity and serum insulin are associated with decreased ovarian reserve markers in CCS. Design: Retrospective single-center cohort study. Methods: Data of 191 female survivors of childhood cancer were analyzed. Median follow-up time was 18.8 (2.3-48.8) years. Outcome measures were serum anti-Mü llerian hormone (AMH) and total follicle count (FC). Potential risk factors were: BMI; body composition measures, determined by dualenergy X-ray absorptiometry (total fat percentage, lean body mass, and visceral fat percentage); and fasting insulin. Results: Lower serum AMH was found in obese subjects (β (%) K49, P=0.007) and in subjects with fasting insulin in the highest