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

Abstract

Abstract. This meta-analysis was designed to assess the overall performance of GnRHa in preserving the ovarian function in young women undergoing chemotherapy. Electronic literature databases including Pubmed, MEDLINE, Cochrane library, Embase, CNKI and Wanfang were searched for articles published till November, 2013. The articles written in both Chinese and English were considered. Only randomized controlled trials (RCTs) were selected. Main Outcome Measure was evaluated by assessing the post-chemotherapy ovarian function. A random-effects model was used to calculate the risk ratio (RR) and associated 95% confidence intervals (95% CI). Out of the eight RCTs including 621 patients, 321 women were treated with GnRHa during chemotherapy, 9.66% of whom suffered premature ovarian failure (POF). On the other hand, 26.67% of the remaining 300 women suffered POF. More women treated without GnRHa experienced post-chemotherapy POF, yielding an RR of 0.45 [chemotherapy plus GnRHa vs. chemotherapy alone, 95% confidence interval (CI) (0.22, 0.92)]. Based on the available studies, GnRHa plays an important role in the prevention of post-chemotherapy POF, but does not exhibit its protective effects in fertility.

Ovarian protection with gonadotropin-releasing hormone agonists during chemotherapy in cancer patients: From biological evidence to clinical application

“…Several meta-analyses have been conducted to summarize the results from the available randomized trials performed to investigate the clinical efficacy of temporary ovarian suppression with GnRHa during chemotherapy in premenopausal cancer patients (Table 6) [101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120]. The oldest meta-analyses included also prospective non-randomized studies, some were restricted to a single tumor type (i.e.…”

Premature ovarian insufficiency: the context of long-term effects

“…Shielding or ovarian transposition during radiotherapy and fertility sparing surgery should be considered in young females undergoing cancer treatment. GnRH analogue given during chemotherapy significantly reduces the risk of POI in young cancer patients, but does not exhibit its protective effects in fertility [ 16 , 17 ].…”

Gonadotropin‐releasing hormone agonists for ovarian protection during cancer chemotherapy: systematic review and meta‐analysis

“…Despite numerous attempts to synthesize the results in several meta-analyses [9][10][11][12][13][14][15][16][17][18][19][20] , the subject remains controversial. This systematic review and meta-analysis was designed to evaluate the efficacy of GnRHa in ovarian reserve protection before and during cancer chemotherapy in premenopausal women without previous diagnosis of infertility.…”