Gonadotropin Releasing Hormone agonist may minimize premature ovarian failure in young women undergoing autologous stem cell transplantation

Gonadotropin-releasing hormone agonist cotreatment in conjunction with conditioning chemotherapy before stem cell transplantation may significantly decrease gonadotoxicity and premature ovarian failure in lymphoma but not in leukemia patients.

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Authors

Zeev Blumenfeld, M.D., Biren Patel, M.D., Ronit Leiba, M.Sc., Tsila Zuckerman, M.D.

Volume 98, Issue 5, Pages 1266-1270.e1, November 2012

Abstract

Objective:

To compare the rate of premature ovarian failure (POF) after stem cell transplantation (SCT) in young women receiving GnRH-agonist (GnRH-a) in conjunction with gonadotoxic chemotherapy.

Design:

Prospective, nonrandomized study.

Setting:

Tertiary university hospital.

Patients:

Ninety-five women received conditioning chemotherapy, with or without GnRH-a before SCT. Complete information was available only for 83 patients.

Interventions:

Conditioning chemotherapy, with or without GnRH-a before SCT.

Main Outcome Measures:

Cyclic ovarian function (COF), or premature ovarian failure (POF) after SCT.

Results:

There were no significant differences in age, chemotherapy treatment, or diagnoses between the study and control groups. In the GnRH-a group 38.3% (18/47) patients resumed COF compared to 11.1% (4/36) for patients who did not receive GnRH-a. Patients who resumed COF were an average 3.7 years (median 3 years) younger at the time of transplantation than those who experienced POF. GnRH-a had a significant effect on long term COF in patients with lymphomas [66.7% (14/21) for GnRH-a group vs. 18.2% (2/11) for control,] but not for leukemia patients.

Conclusion:

GnRH-a cotreatment in parallel to conditioning chemotherapy before SCT may significantly decrease the gonadotoxicity and POF from 82% to 33% in lymphoma but not in leukemia patients.

Read the full text at: http://www.fertstert.org/article/S0015-0282(12)01952-8/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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