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RecruitingNCT02595255CHANCEUpdated Aug 12, 2026

AMH as a Predictor of Infertility Risk in Children With Cancer (CHANCE)

An observational study in Fertility Preservation, Lymphoma and Pediatrics Cancer, sponsored by Erasme University Hospital. Recruiting at 8 sites in 2 countries. Open to female participants aged 3 Years to 14 Years. Per ClinicalTrials.gov, last updated 2026-08-12.

Sponsored by Erasme University Hospital · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
275
Ages
3 Years to 14 Years
Sex
Female
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Study summary

While most of the children spontaneously recover menstruation or experienced normal puberty after chemotherapy, their ovarian reserve may be impaired by treatment inducing future infertility. Fertility preservation is currently proposed for selected prepubertal patients with a high risk of premature ovarian failure after treatment (mostly conditioning regimen for bone marrow transplantation). For patients with low or moderate risks, counselling is very difficult and no fertility preservation procedure is usually proposed for these patients as no marker of the ovarian reserve has been validated in this young population to assess the individual risk.

The primary objective of the study is to prevent long-term treatment-related infertility by detecting the young patients who normally progressed to menarche but have a reduced ovarian reserve. These patients may benefit from particular follow-up and fertility preservation procedure.

Read the detailed description

In this clinical trial, we will prospectively evaluate the AMH (Antimüllerian Hormone) level before and after treatment (up to 18 years old) in a large cohort of pre- and post-pubertal children treated for cancer. The children enrolled are young patients between 3 and 14 year old who are newly diagnosed with cancer or benign diseases treated by chemotherapy and/or pelvic irradiation. They belong to one of these 3 groups (modified from Wallace et al, 2005):

  • High risk
  • Moderate/Low risk
  • No risk (control group)

Primary endpoint:

Evaluate AMH as a potential biomarker of ovarian reserve in prepubertal/pubertal girl treated by chemotherapy (classified according to the AAD(Alkylating Agent Dose) score)

Secondary endpoints:

  • Evaluate the association between the post-treatment ovarian reserve and the AMH pretreatment values in patients considered as moderate or low risk.
  • Identify new patients group who may benefit from fertility preservation
  • Compare the gonadotoxicity of chemotherapy regimen according to the pubertal status.
  • Study the relation between the AMH levels and the pubertal age, menstruation cycle regularity, hormonal levels (FSH (follicle stimulating hormone), œstradiol, and testosterone) and bone age.

Different parameters will be assessed at inclusion, end of the treatment and during the follow-up (every year during the first 3 years and then every 2 years until the end of the study) Oncological outcome The patients will be followed up for progression and survival as per standard local practice.

Ovarian reserve and function:

Ovarian reserve will be evaluated based on hormonal dosages at different times of the study: FSH, AMH, estradiol, testosterone and LH (luteinizing hormone). Menstrual function will be evaluated by collecting information of the pubertal status (spontaneous or induced puberty) and menstrual cycle characteristics

Puberty evaluation:

All children will have an evaluation of the TANNER pubertal stage at 9 years of age (or later if > 9 years old at the time of inclusion) and once a year until the end of puberty (when patients reach Tanner stage 5). An X-ray of the left hand and wrist will be carried out for bone age evaluation at 9-11 and 13 years old.

02

Conditions studied

  • Fertility Preservation
  • Lymphoma
  • Pediatrics Cancer
  • Gonadotropin-releasing Hormone Agonist

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Keywords

  • chemotherapy
  • lymphoma
  • children
  • fertility
  • GnRH (gonadotropin-releasing hormone) analogues
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Who can participate

Ages eligible
3 Years to 14 Years
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The population for this trial is patients between 3 and 14 year old newly diagnosed with cancer or benign diseases treated by chemotherapy and/or pelvic irradiation with high or moderate risk of inducing premature ovarian insufficiency. The "no risk" group includes patients with chronic benign diseases (as pneumology or gastroenterology diseases, congenital hypothyroidism, growth hormone deficiency or RCIU…) or malignancies who will not receive any chemotherapy or other gonadotoxic treatment.

Inclusion criteria

  • Patients from 3 to 14 year old included - Belong to one of these 3 groups (modified from Wallace et al, 2005):

    • High risk : Conditioning therapy for bone marrow transplantation or pelvic irradiation
    • Moderate/Low risk : Pathologies treated with chemotherapy regimen with moderate or low risk of inducing ovarian function insufficiency: AML, osteosarcoma, Ewing sarcoma, neuroblastoma, non-Hodgkin lymphoma, Hodgkin lymphoma, soft tissue sarcoma, ALL, Wilms tumour, retinoblastoma.
    • No risk (control group) : patients with chronic benign diseases or malignancies who don't receive any chemotherapy or other gonadotoxic treatment.

Exclusion criteria

Exclusion Criteria:

  • CNS (central nervous system) irradiation, cerebral tumour
  • Current or previous ovarian disease/surgery
  • Familial history of premature ovarian failure (no iatrogenic or surgical origins)
  • Previous known severe chronic disease potentially affecting normal growth or puberty (diseases inducing malnutrition, anorexia, genetic/congenital disorders as Turner, Kallman, BPES(Blepharophimosis, ptosis, and epicanthus inversus syndrome) syndromes, uncontrolled severe diabetes, Cushing Syndrome, auto-immune diseases, cystic fibrosis, severe renal dysfunction)
  • Genetic/congenital disorders inducing mental retardation
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
275 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • High risk

    Conditioning therapy for bone marrow transplantation or pelvic irradiation. Fertility preservation is usually already proposed in this group of patients. No intervention.

    Other: No intervention

  • Moderate/low risk

    Pathologies treated with chemotherapy regimen with moderate or low risk of inducing ovarian function insufficiency: AML (Acute myeloid leukemia), osteosarcoma, Ewing sarcoma, neuroblastoma, non-Hodgkin lymphoma, Hodgkin lymphoma, soft tissue sarcoma, ALL (acute lymphoblastic hormone), Wilms tumour, retinoblastoma. This is the study group we will compare with high risk and no risk patients. No intervention

    Other: No intervention

  • No risk

    Patients with chronic benign diseases or malignancies who don't receive any chemotherapy or other gonadotoxic treatment. No intervention

    Other: No intervention

Interventions

  • OtherNo intervention

    No intervention

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What researchers measure

Primary outcomes

  1. AMH marker

    Blood test collection for serum storage. AMH values will be compared in the different groups and correlated with the cumulative doses of alkylating agents

    Time frame: screening, 1 year after screening, every year during the first 3 year of follow-up, every 2 years until 18 year old

Secondary outcomes

  1. Premature ovarian failure (POF)

    Blood test collection for serum storage. FSH, E2 and AMH measurement and pubertal status. POF rate will be compared between groups

    Time frame: screening, 1 year after screening, every year during the first 3 year of follow-up, every 2 years until 18 year old

  2. Ovarian reserve

    relation between the AMH levels, pubertal age, menstruation cycle regularity, hormonal levels (FSH, œstradiol, and testosterone at 16 year old) and bone age

    Time frame: screening, 1 year after screening, every year during the first 3 year of follow-up, every 2 years until 18 year old

06

Study locations

8 of 8 sites recruiting
  • Centre Hospitalier Chrétien (CHC)- Clinique de l'espérance
    Montegnée, Liège 4420, Belgium
    • Audrey Courtois · Contact · audrey.courtois@chc.be · +32 4 355 42 21
    • Nadine Francotte · Principal investigator
    Recruiting
  • Universitair Ziekenhuis Antwerpen
    Antwerp, 2650, Belgium
    Recruiting
  • Hôpital Universitaire Reine Fabiola (HUDERF)
    Brussels, 1020, Belgium
    Recruiting
  • Universitair Ziekenhuis Brussels
    Brussels, 1090, Belgium
    Recruiting
  • Universitair Ziekenhuis Leuven
    Leuven, 3000, Belgium
    Recruiting
  • Centre Hospitalier Régional (CHR)-Citadelle
    Liège, 4000, Belgium
    Recruiting
  • Centre Oscar Lambret
    Lille, 59000, France
    Recruiting
  • CHRU Lille-Hôpital Jeanne de Flandre
    Lille, 59037, France
    Recruiting
07

References and documents

Publications

  • Brougham MF, Crofton PM, Johnson EJ, Evans N, Anderson RA, Wallace WH. Anti-Mullerian hormone is a marker of gonadotoxicity in pre- and postpubertal girls treated for cancer: a prospective study. J Clin Endocrinol Metab. 2012 Jun;97(6):2059-67. doi: 10.1210/jc.2011-3180. Epub 2012 Apr 3. PubMed 22472563 ↗
  • Wallace WH, Smith AG, Kelsey TW, Edgar AE, Anderson RA. Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation. Lancet Oncol. 2014 Sep;15(10):1129-36. doi: 10.1016/S1470-2045(14)70334-1. Epub 2014 Aug 14. PubMed 25130994 ↗
  • Demeestere I, Simon P, Dedeken L, Moffa F, Tsepelidis S, Brachet C, Delbaere A, Devreker F, Ferster A. Live birth after autograft of ovarian tissue cryopreserved during childhood. Hum Reprod. 2015 Sep;30(9):2107-9. doi: 10.1093/humrep/dev128. Epub 2015 Jun 9. PubMed 26062556 ↗
  • Imbert R, Moffa F, Tsepelidis S, Simon P, Delbaere A, Devreker F, Dechene J, Ferster A, Veys I, Fastrez M, Englert Y, Demeestere I. Safety and usefulness of cryopreservation of ovarian tissue to preserve fertility: a 12-year retrospective analysis. Hum Reprod. 2014 Sep;29(9):1931-40. doi: 10.1093/humrep/deu158. Epub 2014 Jun 22. PubMed 24958067 ↗
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Registry details

Key details

Study ID
NCT02595255
Lead sponsor
Erasme University Hospital
Collaborators
Queen Fabiola Children's University Hospital
Responsible party
Sponsor
First posted
Nov 3, 2015
Start date
Apr 2014
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2041 (estimated)
Last update
Aug 12, 2026

Study contacts

Isabelle Demeestere, PhD
Contact
isabelle.demeestere@ulb.be
+32 2 555 65 92
Julie Dechene
Contact
julie.dechene@ulb.be
+32 2 555 63 58
Isabelle Demeestere, PhD
study director · Erasme ULB- Belgium
Alina Ferster
principal investigator · Queen Fabiola children's university hospital- Belgium
Christine Decanter
principal investigator · CHRU Lille, France

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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