Anti-Müllerian Hormone (AMH) reflects primordial follicle pool size and is the best singl...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | BMA-AMH-OVARIAN-RESERVE-BSO-TIMING |
|---|---|
| Тип | Клінічна застосовність |
| Статус | переглянуто 2026-05-18 | потрібне рев’ю клінічної застосовності |
| Хвороби | DIS-OVARIAN |
| Джерела | SRC-NCCN-GENETIC-FAMILIAL-BREAST-OVARIAN-2025 |
Дані про клінічну застосовність
| Біомаркер | BIO-AMH-OVARIAN-RESERVE |
|---|---|
| Варіант | Anti-Müllerian Hormone — ovarian reserve / BSO timing counselling in BRCA1/2 carriers |
| Хвороба | DIS-OVARIAN |
| Рівень ESCAT | X |
| Рекомендовані комбінації | BRCA1/2 carrier pre-BSO fertility counselling: AMH + antral follicle count + age determines oocyte cryopreservation feasibility, BRCA1: BSO at 35-40 after childbearing complete; BRCA2: 40-45, Post-BSO menopausal-hormone-therapy decision: consider until natural menopause age (50-51) in carriers without prior breast cancer, per NCCN Genetic 2025 + Domchek 2014 |
| Протипоказана монотерапія | AMH must NOT be used as an ovarian cancer screening test or as a basis to delay BSO beyond NCCN-recommended age in confirmed BRCA1/2 carriers |
| Підсумок доказів | Anti-Müllerian Hormone (AMH) reflects primordial follicle pool size and is the best single biomarker of ovarian reserve. In the BRCA1/2 carrier population, AMH is used as DECISION-SUPPORT for risk-reducing salpingo-oophorectomy (RSSO / BSO) timing, fertility counselling, and oocyte cryopreservation planning — NOT as a screening test for ovarian cancer. NCCN Genetic/Familial Breast/Ovarian 2025 recommends BSO at age 35-40 (BRCA1) / 40-45 (BRCA2) after completion of childbearing. AMH is one input informing the personalised cost/benefit of pre-BSO oocyte cryopreservation and post-BSO menopausal hormone replacement decisions. AMH does NOT predict ovarian cancer risk and does NOT replace germline-mutation-driven BSO recommendation. ESCAT X — AMH does not drive cancer-treatment selection; categorised as reproductive-counselling support. |
Нотатки
STUB pending two-Co-Lead signoff. A dedicated IND-BRCA-CARRIER-FERTILITY-PRESERVATION Indication entity (gated on age + reproductive intent) would be the cleanest home for this biomarker; the listed surveillance Indications are adjacent but not precisely fitted to the fertility-counselling use case. Engine must explicitly de-couple BSO timing from AMH value — AMH never delays BSO in a confirmed carrier; it only informs WHETHER to attempt oocyte cryopreservation before BSO and HOW many cycles to plan.
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