Fertility in women survivors of hematological malignancies: what is the real role of GnRH analogue treatment?

Clin Exp Obstet Gynecol. 2012;39(4):504-8.

Abstract

Purpose of investigation: The aim of this study was to evaluate the ovarian function in women who received or not gonadotropin-releasing hormone (GnRH) analogue co-treatment compared to the control group that did not receive it.

Materials and methods: This study analyzed 124 patients affected by hematological diseases between 1998 and 2007. The data were analyzed using R (v 2.9.1).

Results: In the women treated with GnRH analogue, the authors found 33% post-treatment secondary amenorrhea and 6% had a pregnancy post-treatment, while in the other group the prevalence were respectively 49% and 4% (p n.s.). Moreover, in multivariate analysis the authors found bone marrow transplantation to be a risk factor for secondary amenorrhea, while the association of chemotherapy with radiotherapy was a protective factor (p < 0.05). Finally, none of the considered factors were predictive of pregnancy achievement post-treatment.

Conclusions: The authors found no statistical evidence to support that Gn-RH analogue treatment preserves ovarian follicular reserve during hematologic cancer treatment, but more evidence must be obtained.

MeSH terms

  • Adult
  • Amenorrhea / chemically induced
  • Antineoplastic Agents / adverse effects*
  • Drug Therapy, Combination
  • Female
  • Fertility
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Hematologic Neoplasms / drug therapy*
  • Hodgkin Disease / drug therapy
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy
  • Lymphoma, Non-Hodgkin / drug therapy
  • Multivariate Analysis
  • Ovary / drug effects*
  • Ovary / physiology
  • Pregnancy
  • Primary Ovarian Insufficiency / chemically induced
  • Primary Ovarian Insufficiency / prevention & control*
  • Prospective Studies
  • Survivors
  • Young Adult

Substances

  • Antineoplastic Agents
  • Gonadotropin-Releasing Hormone