Ovarian preservation with gonadotropin-releasing hormone analog during chemotherapy

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 (inset 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.