The effects of childhood cancer therapy on ovarian reserve tests and on pubertal development within 5 years were compared with a control group. The study group was composed of 41 patients who underwent chemotherapy during pre-menarche (subgroup A; n = 15) and after menarche (subgroup B; n = 26); the control group was composed of 44 patients admitted with non-cancer related diseases (in total n = 85). Mean total ovarian volume and total antral follicle counts on ultrasound examination were significantly lower in the study group compared with the control group (3.5 +/- 2.3 versus 5.2 +/- 2.4 ml; P = 0.001; and 3.4 +/- 3.3 versus 8.6 +/- 3.5; P < 0.001, respectively). Mean FSH level was significantly higher in the study group (13.5 +/- 16.2 versus 7.3 +/- 2.7 mIU/ml; P = 0.017). Anti-Mullerian hormone levels in subgroup A A were significantly higher than in subgroup B (1.8 +/- 0.1 versus 1.5 +/- 0.08 pg/dl; P = 0.034). In conclusion ovarian volume, antral follicle count and FSH can be used for evaluating the harmful effect of cancer chemotherapy on ovarian follicles. Post-menarche, Anti-Mullerian values reveal that ovarian follicles are more sensitive to the devastating effects of cytotoxic treatment. (C) 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.