Association of uterine artery Doppler, follicle-stimulating hormone, and anti-Müllerian hormone with post-chemotherapy ovarian reserve in reproductive-age colorectal cancer patients

doi:10.4251/wjgo.v18.i8.120985

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 8

This Article

(1)

(3)

(0)

(1)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Oncology

ISSN

1948-5204

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Aug 15, 2026; 18(8): 120985
Published online Aug 15, 2026. doi: 10.4251/wjgo.v18.i8.120985

Association of uterine artery Doppler, follicle-stimulating hormone, and anti-Müllerian hormone with post-chemotherapy ovarian reserve in reproductive-age colorectal cancer patients

Chun-Ya Chen, Lin-Ling Tan, Jun-Yi Zhang, Ya-Ping Zhang

Chun-Ya Chen, Lin-Ling Tan, Jun-Yi Zhang, Department of Ultrasonic Medicine, Yuyao Maternal and Child Health Hospital, Ningbo 315400, Zhejiang Province, China

Ya-Ping Zhang, Department of Oncology, The Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou 311200, Zhejiang Province, China

Author contributions: Chen CY participated in research design and data collection; Tan LL is responsible for data analysis and paper writing; Zhang JY participated in research design and data analysis; Zhang YP is responsible for fund application, data analysis, review and editing, communication and coordination, ethical review, copyright and license and follow-up; and all authors have read and accepted the final manuscript.

AI contribution statement: AI tools (specifically Grammarly and DeepL) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Institutional review board statement: The research was reviewed and approved by the Yuyao Maternal and Child Health Hospital, No. YFYLS-2026-001.

Informed consent statement: The requirement for written informed consent was waived by the Ethics Committee because of the retrospective nature of the study.

Conflict-of-interest statement: No conflict of interest is associated with this work.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: No other data available.

Corresponding author: Ya-Ping Zhang, Associate Chief Physician, Department of Oncology, The Affiliated Xiaoshan Hospital, Hangzhou Normal University, No. 728 Yucai North Road, Xiaoshan District, Hangzhou 311200, Zhejiang Province, China. fuyou_chun2025@163.com

Received: March 17, 2026
Revised: March 30, 2026
Accepted: May 7, 2026
Published online: August 15, 2026
Processing time: 142 Days and 17.2 Hours

Abstract

BACKGROUND

Colorectal cancer (CRC) incidence is rising among reproductive-age women, yet chemotherapy frequently compromises ovarian reserve, impairing fertility. Ovarian reserve assessment traditionally relies on serum follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH), while uterine artery Doppler parameters - pulsatility index (PI), resistance index (RI), and peak systolic velocity (PSV) - reflect ovarian perfusion. However, their combined correlation with post-chemotherapy ovarian reserve remains underexplored. We hypothesize that integrating these parameters will enhance predictive accuracy for diminished ovarian reserve, informing fertility preservation strategies.

AIM

To investigate correlations of uterine artery blood flow, FSH, and AMH with ovarian reserve post-chemotherapy in reproductive-aged CRC patients.

METHODS

This study included 110 reproductive-aged women with CRC who received chemotherapy from March 2021 to September 2024. Based on criteria assessed three months post-chemotherapy, they were divided into diminished (n = 50) and normal (n = 60) ovarian reserve groups. Uterine artery PI, RI, PSV, serum FSH, and AMH were compared. Correlations and predictive efficacy were analyzed using Pearson correlation and receiver operating characteristic (ROC) curves.

RESULTS

The diminished ovarian reserve group exhibited significantly higher uterine artery PI, RI, and serum FSH levels, but lower PSV and serum AMH levels than the normal ovarian reserve group (P < 0.05). Correlation analysis showed PI, RI, and FSH were positively correlated with ovarian reserve decline (r = 0.395, 0.420, 0.378; P < 0.05), whereas PSV and AMH were negatively correlated (r = -0.506, -0.614; P < 0.05). ROC curve analysis revealed AMH had the best predictive value among single markers [area under the curve (AUC) = 0.895], with AUCs of 0.726, 0.733, 0.791, and 0.723 for PI, RI, PSV, and FSH, respectively. Combined detection of all five indicators increased the AUC to 0.950, with 94% sensitivity and 90% specificity, significantly outperforming any single indicator (P < 0.05).

CONCLUSION

In post-chemotherapy reproductive-age CRC patients, elevated PI, RI, FSH and reduced PSV, AMH correlate with diminished ovarian reserve. Combined testing at three months aids risk identification and fertility preservation.

Keywords: Colorectal neoplasms; Ovarian reserve function; Ultrasonography; Blood flow parameters; Follicle-stimulating hormone; Anti-Müllerian hormone; Women

Core Tip: Combined assessment of uterine artery Doppler parameters [pulsatility index (PI), resistance index (RI), and peak systolic velocity (PSV)] with serum follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels demonstrates superior predictive value for diminished ovarian reserve in reproductive-aged colorectal cancer patients after chemotherapy. The combined detection achieved an area under the curve of 0.950, significantly outperforming any single indicator, with PI, RI, and FSH positively correlated, while PSV and AMH negatively correlated with ovarian reserve decline. This multimodal approach provides a non-invasive, comprehensive strategy for early identification of chemotherapy-induced ovarian damage.