Ovarian protection and safety of gonadotropin-releasing hormone agonist after cervical cancer surgery: systematic review and meta-analysis

Abstract

Background: This meta-analysis was performed using Stata (15.0), and sought to systematically evaluate the domestic application value of the gonadotropin-releasing hormone agonist (GNRH-a) after cervical cancer, and explore its protective effect on the ovaries during chemotherapy. In many studies, the effectiveness and safety of GNRH-a are not consistent, and there is great controversy. Therefore, it is very important to systematically evaluate the protection and safety of GNRH-a after cervical cancer surgery.Methods: PubMed, Cochrane Library, and Web of Science databases were systematically searched to retrieve articles on domestic trials examining the use of GNRH-a treatment in cervical cancer patients, published from January 2014 to January 2021, which were reviewed according to the inclusion and exclusion criteria of this study. The meta-analysis of the included study data was conducted using Stata 15.0.Results: In total, 10 articles were included in the meta-analysis, comprising 579 ovarian-reserved cervical cancer subjects, all of whom received 4-6 standardized courses of PC (Paclitaxel + Cisplatin) chemotherapy.The following statistically significant differences were found: bovine follicle stimulating hormone [odds

Reproductive and Obstetric Outcomes after Fertility-Sparing Treatments for Cervical Cancer: Current Approach and Future Directions

“…If there are potential contraindications for GnRH agonists, then an alternative option to impede accelerated follicle degradation secondary to chemotherapy or radiotherapy is to use GnRH antagonists [ 26 ]. A recent systematic review of GnRH analogue administration during chemotherapy with commonly used chemotherapeutic drugs for cervical cancer treatment (Paclitaxel and Cisplatin) showed a significant protective effect on ovarian reserve as reflected by patient’s post-therapy hormonal profile [ 27 ]. Although GnRH analogs are used in a fertility-sparing approach, they are applicable in urgent cases and when other non-surgical fertility-preserving options are not feasible [ 28 , 29 , 30 ].…”

Gynotoxic Effects of Chemotherapy and Potential Protective Mechanisms

“…In an analysis by Yuan et al [ 274 ] involving 579 Chinese patients of 20–45 years of age treated with standard chemotherapy, i.e., 4–6 cycles of paclitaxel plus cisplatin, for cervical cancer, the ovarian reserve status (AMH, FSH, E2) was determined, and goserelin administration was included in the study group. Improvements in ovarian reserve function were demonstrated in women using goserelin compared to a control group treated with cytostatics alone [ 274 ]. In contrast, Wang et al [ 275 ] evaluated the effect of goserelin on ovarian function in 149 women of 18–45 years of age undergoing chemotherapy for breast cancer (stage I–III).…”