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Title of Journal: Breast Cancer Res Treat

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Abbravation: Breast Cancer Research and Treatment

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Springer US

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DOI

10.1016/j.ajps.2015.09.001

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1573-7217

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Pharmacological interventions for fertility preser

Authors: Irit BenAharon Anat GafterGvili Leonard Leibovici Salomon M Stemmer
Publish Date: 2010/06/23
Volume: 122, Issue: 3, Pages: 803-811
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Abstract

The rate of chemotherapyinduced ovarian failure CIOF has been reported as 14–100 and is age and agentdependent The role of GnRH analogs GnRHa and oral contraceptives OC in the prevention of CIOF is questionable We performed a systematic review and a metaanalysis of studies assessing the efficacy of hormonal interventions in reducing CIOF in cancer or systemic lupus erythematosus SLE patients treated with chemotherapy MEDLINE EMBASE and conference proceedings were searched until October 2009 From 504 potentially relevant references 21 comparative studies were included for review and analysis Data were collected to determine the risk ratio RR for amenorrhea FSH levels pregnancy rate and biomarkers for ovarian reserve Sixteen studies SLE 4 studies 85 patients malignancy 12 studies 596 patients which assessed GnRHa for fertility preservation prior to chemotherapy were included in the metaanalysis Five studies which evaluated the use of OC were systematically reviewed Metaanalysis revealed that GnRHa are effective in reducing amenorrhea rates in all patients RR 026 95 CI 014–049 Pregnancy rate was higher in the GnRHa arm The advantage of GnRHa was shown only in observational studies but not in randomized controlled trials Biomarkers for ovarian reserve were similar in both arms Studies evaluating the efficacy of oral contraceptives in preserving ovarian function showed inconclusive results GnRHa appears to improve menstruation resumption Nevertheless randomized prospective trials are less conclusive for their real value in conserving ovarian reserve and pregnancy Largescale prospective randomized trials are warranted to evaluate the role of GnRHa in preventing CIOF

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