Ovarian preservation with gonadotropin‐releasing hormone analog during chemotherapy

Abstract

Objective: After the improved long-term survival in young women with cancer undergoing chemotherapy, the preservation of their future fertility has been the focus of recent interest. We studied whether gonadotropin-releasing hormone (GnRH) analogs could prevent the early onset of ovarian insufficiency post-chemotherapy and protect fertility. Methods: The patients were divided into two groups. Group A consisted of post-menarche patients aged 12-45 years (n = 15), who received chemotherapy but no GnRH analog protection. Group B consisted of post-menarche patients aged 12-45 years (n = 15), who received chemotherapy with GnRH analog. The gonadotropin values in the two groups were checked. Both groups received a multi-agent chemotherapy regimen (bleomycin, etoposide, cisplation, Taxol, carboplatin), (Taxol, cisplatinum) and (vincristin, actinomycin, cyclophosphamide) In group B, the GnRH analog was diphereline (3/75 mg). It was administered each month before and during treatment with chemotherapy. The first dose was administered 7 days before starting chemotherapy. Result: In group A, five patients (33%) had amenorrhea and premature ovarian failure. The laboratory values in these five patients showed increased gonadotropin. In group B, the most of patient resumed menstruation after 2-4 months. All these patients had a normal titer of gonadotropin. Conclusion: The GnRH analog co-treatment should be considered in every woman of reproductive age receiving chemotherapy.

Fertility status of Hodgkin lymphoma patients treated with chemotherapy and adjuvant gonadotropin-releasing hormone analogues

“…Previously published randomized studies with GnRH-a during HL chemotherapy evaluated the rate of chDOR after non-standardized chemotherapy regimen [16,18]. Our study confirmed significant differences in fertility outcomes among different chemotherapy groups and thus suggested optimum chemotherapy regarding fertility preservation in HL patients.…”

Protection of ovarian function by GnRH agonists during chemotherapy: A meta-analysis

“…1) (11)(12)(13)(14)(15)(16)(17)(18). A total of 321 women were treated with GnRHa during their chemotherapy, while 300 women underwent chemotheray without GnRHa.…”

“…Among the trials in our analysis, four (11,14,16,18) were conducted on patients younger than 40 years. Because of the limited data, we could not estimate the precise function of GnRHa in this patient group.…”

Update on fertility preservation in young women undergoing breast cancer and ovarian cancer therapy

“…A total of six randomized trials in patients with breast cancer [51][52][53][54][55][56] and one in women with ovarian cancer (which was positive) [57] have been published. Conflicting results on the efficacy of this strategy have been reported in these trials; however, several limitations of these studies should be considered [58].…”