Failure of Ovarian Suppression With Gonadotropin-Releasing Hormone Analogs to Preserve Fertility

Oktay, Kutluk; Turan, Volkan

doi:10.1001/jamaoncol.2015.3252

Cited by 25 publications

(18 citation statements)

References 9 publications

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“…There remains uncertainty concerning the efficacy or otherwise of trying to protect ovarian function from chemotherapy with GnRH-agonist mediated gonadotrophin suppression [17].…”

Section: Discussionmentioning

confidence: 99%

GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial

et al. 2017

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“…There remains uncertainty concerning the efficacy or otherwise of trying to protect ovarian function from chemotherapy with GnRH-agonist mediated gonadotrophin suppression [17].…”

Section: Discussionmentioning

confidence: 99%

GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial

et al. 2017

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“…[132][133][134] However, the impact of these meta-analyses are limited by flaws such as only examining women with breast cancer and only including trials that were not adequately powered and did not use blinding and/ or a placebo condition. 135,136 Further, results from earlier meta-analyses were inconsistent, with some showing a potential benefit of GnRH to preservation of ovarian function, [137][138][139] while other reviews have been unable to come to this conclusion. 140,141 Also, limited data are available on the long-term impact of GnRH on preservation of ovarian function, 132 though a 5-year follow-up analysis of a randomized trial showed that administration of a GnRH agonist does not significantly impact premature ovarian failure or future pregnancy rate.…”

Section: Options For Femalesmentioning

confidence: 99%

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Coccia¹,

Pappo²,

Beaupin³

et al. 2018

J Natl Compr Canc Netw

239

194

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“…91 However, many of the existing studies demonstrating the protective value of GnRH agonists have important flaws that may invalidate their results, including inconsistent definitions of ovarian reserve and lack of blinding or placebo. 92 A randomized trial of triptorelin, a GnRH agonist, in lymphoma patients undergoing alkylating chemotherapy showed that premature ovarian failure, defined as FSH ≥40 mIU/ml, occurred in about 20% of patients in both groups without a significant difference with GnRH agonist use. 93 Therefore, additional study is needed to elucidate the benefit, if any, of GnRH agonists or other hormonal agents on the preservation of ovarian reserve during chemotherapy.…”

Section: Endocrinologic Outcomes Following Chemotherapy For Eocmentioning

confidence: 99%

Fertility‐sparing treatment for early‐stage epithelial ovarian cancer: Contemporary oncologic, reproductive and endocrinologic perspectives

Mandelbaum

Klar

Takiuchi

et al. 2020

J of Obstet and Gynaecol

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Aim Epithelial ovarian cancer (EOC) can be a devastating diagnosis in women of reproductive age who desire future fertility. However, in early‐stage disease, fertility‐sparing surgery (FSS) can be considered in appropriately selected patients. Methods This is a narrative descriptive review of the recent literature on FSS for EOC from oncologic, reproductive and endocrinologic perspectives. Results The recurrence rate following FSS performed for stage I EOC in published retrospective studies collectively is 13% but ranges from 5 to 29%, while mortality ranges from 0 to 18%. Five‐year disease‐free survival following FSS is over 90% but decreases with higher stage and grade. Recurrences following FSS are more likely to be localized with a more favorable prognosis compared to recurrences following radical surgery. Adjuvant chemotherapy is recommended in women with high‐risk disease, and strategies to minimize gonadotoxicity during chemotherapy such as gonadotropin‐releasing hormone (GnRH) agonists may be considered. Oocyte, embryo and/or ovarian cryopreservation can also be offered to patients desiring future biologic children. Reproductive outcomes following FSS, including pregnancy and miscarriage rates, resemble those of the general population, with a chance of successful pregnancy of nearly 80%. Conclusion In retrospective data, FSS appears to be oncologically safe in stage IA and IC grade 1–2 non‐clear cell EOC. In patients with grade 3 tumors or clear cell histology, treatment can be individualized, weighing a slightly higher risk of recurrence with fertility goals. A multidisciplinary approach with oncology and reproductive endocrinology may be of utility to help these patients achieve their fertility goals.

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Failure of Ovarian Suppression With Gonadotropin-Releasing Hormone Analogs to Preserve Fertility

Cited by 25 publications

References 9 publications

GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial

GnRH agonist for protection against ovarian toxicity during chemotherapy for early breast cancer: the Anglo Celtic Group OPTION trial

Adolescent and Young Adult Oncology, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology

Fertility‐sparing treatment for early‐stage epithelial ovarian cancer: Contemporary oncologic, reproductive and endocrinologic perspectives

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