Effect of Radioactive Iodine Ablation Therapy on Ovarian Reserve in Patients with Differentiated Thyroid Cancer

Objective: Radioactive iodine (RAI) ablation therapy is widely used in the management of differentiated thyroid cancer (DTC). However, its potential adverse effects on ovarian reserve in premenopausal women remain an important clinical concern. This study aimed to investigate the association between RAI ablation therapy and ovarian reserve in premenopausal patients with differentiated thyroid cancer. Materials and Methods: This study included 66 premenopausal women aged 18–45 years with DTC. Among these patients, 46 received RAI therapy and 20 did not. Serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and thyroid-stimulating hormone (TSH) levels were measured. To evaluate in-dependent association between RAI therapy and ovarian reserve, a multivariable linear regres-sion analysis was performed with AMH as the dependent variable. Results: AMH levels were significantly lower in patients who received RAI therapy compa-red with those who did not (1.34 ± 0.37 ng/mL vs 1.79 ± 0.25 ng/mL, p = 0.001). No signifi-cant differences were observed between the groups in serum FSH, LH, or E2 levels. AMH levels did not differ significantly according to RAI dose categories of 75, 100, and 150 mCi (p = 0.073). In the multivariable linear regression analysis, RAI therapy remained indepen-dently associated with lower AMH levels (β = −0.41, p = 0.003). Age was also independently associated with AMH levels (β = −0.36, p = 0.010). Conclusion: RAI therapy was associated with lower AMH levels in premenopausal women with DTC, suggesting a potential adverse effect on ovarian reserve. Larger prospective studies are needed to confirm these findings.