Background: Chemotherapy-induced amenorrhea (CIA) is a surrogate for ovarian failure, which is indicative of ovarian failure in young females taking chemotherapy. The CIA lacks sufficient reproducibility and reliability.

Objectives: to assess the anti-Mullerian hormone (AMH) concentrations before and after chemotherapy (CTh) for premenopausal female patients with breast cancer and to correlate AMH values with menopausal status post-CTh.

Subjects and methods: This Prospective cohort study was conducted on 100 subjects at the Medical Oncology Department, Faculty of Medicine, Zagazig University. Pre-menopausal condition is characterized as two or more menstrual cycles in the 120 days before the start of CTh in females aged 18 to 45 years. The following data were obtained from the patient's sheets: patient history, clinical data, and AMH, estrogen, FSH, and LH concentrations were assessed at baseline. Following blood tests were done after the end of the final cycle of CTh.

Results: Our study showed a statistically significant difference between baseline and post-chemotherapy hormonal biomarkers (P <0.05). AMH levels were significantly decreased from( 2.97 ±1.94) to (0.47 ±0.74) post-chemotherapy, and it is a sensitive prediction biomarker for ovarian failure induced by chemotherapy. There was a significant negative correlation between baseline AMH with BMI (P<0.001).

Conclusion: Serum AMH is a sensitive prediction biomarker of ovarian failure induced by chemotherapy, comparable with FSH, LH, and Estradiol levels.