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Breast Cancer Research and Treatment

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01.08.2010 | Clinical trial

Pharmacological interventions for fertility preservation during chemotherapy: a systematic review and meta-analysis

verfasst von: Irit Ben-Aharon, Anat Gafter-Gvili, Leonard Leibovici, Salomon M. Stemmer

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2010

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Abstract

The rate of chemotherapy-induced ovarian failure (CIOF) has been reported as 14–100% and is age- and agent-dependent. The role of GnRH analogs (GnRHa) and oral contraceptives (OC) in the prevention of CIOF is questionable. We performed a systematic review and a meta-analysis 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 meta-analysis. Five studies which evaluated the use of OC were systematically reviewed. Meta-analysis revealed that GnRHa are effective in reducing amenorrhea rates in all patients (RR 0.26, 95% CI 0.14–0.49). 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. Large-scale prospective randomized trials are warranted to evaluate the role of GnRHa in preventing CIOF.

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Knobf MT (2006) The influence of endocrine effects of adjuvant therapy on quality of life outcomes in younger breast cancer survivors. Oncologist 11:96–110CrossRefPubMed

Elis A, Tevet A, Yerushalmi R et al (2006) Fertility status among women treated for aggressive non-Hodgkin’s lymphoma. Leuk Lymphoma 47:623–627CrossRefPubMed

Thewes B, Meiser B, Taylor A et al (2005) Fertility- and menopause-related information needs of younger women with a diagnosis of early breast cancer. J Clin Oncol 23:5155–5165CrossRefPubMed

Sonmezer M, Bang H, Oktay K (2008) GnRH analogues preserve gonadal function without preserving fertility? Oncologist 13:615–617CrossRef

Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, Beck LN, Brennan LV, Oktay K, American Society of Clinical Oncology (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24:2917–2931CrossRefPubMed

Waxman JH, Ahmed R, Smith D et al (1987) Failure to preserve fertility in patients with Hodgkin’s disease. Cancer Chemother Pharmacol 19:159–162CrossRefPubMed

Blumenfeld Z, Avivi I, Linn S et al (1998) Prevention of irreversible chemotherapy-induced ovarian damage in young women with lymphoma by a gonadotropin-releasing hormone agonist in parallel to chemotherapy. Hum Reprod 11:1620–1626

Blumenfeld Z, Shapiro D, Shteinberg M et al (2000) Preservation of fertility and ovarian function and minimizing gonadotoxicity in young women with systemic lupus erythematosus treated by chemotherapy. Lupus 9:401–405CrossRefPubMed

Pereyra Pacheco B, Mendez Ribas JM, Milone G et al (2001) Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report. Gynecol Oncol 81:391–397CrossRefPubMed

10.

Petri M, Brodsky R, Jones R et al (2004) High dose cyclophosphamide can cause ovarian failure. Arthritis Rheum 50(Suppl 9):408

11.

Blumenfeld Z, Eckman A (2005) Preservation of fertility and ovarian function and minimization of chemotherapy-induced gonadotoxicity in young women by GnRH-a. J Natl Cancer Inst Monogr 34:40–43CrossRefPubMed

12.

Dann EJ, Epelbaum R, Avivi I et al (2005) Fertility and ovarian function are preserved in women treated with an intensified regimen of cyclophosphamide, adriamycin, vincristine and prednisone (Mega-CHOP) for non-Hodgkin lymphoma. Hum Reprod 20:2247–2249CrossRefPubMed

13.

Somers EC, Marder W, Christman GM et al (2005) Use of a gonadotropin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus. Arthritis Rheum 52:2761–2767CrossRefPubMed

14.

Castelo-Branco C, Nomdedeu B, Camus A et al (2007) Use of gonadotropin releasing hormone agonists in patients with Hodgkin’s disease for preservation of ovarian function and reduction of gonadotoxicity related to chemotherapy. Fertil Steril 87:703–706

15.

Giuseppe L, Attilio G, Edoardo DN et al (2007) Ovarian function after cancer treatment in young women affected by Hodgkin disease (HD). Hematology 12:141–147CrossRefPubMed

16.

Azem F, Samara N, Cohen T et al (2008) Assessment of ovarian reserve following ovarian tissue banking and/or GnRH-a co-treatment prior to chemotherapy in patients with Hodgkin’s disease. J Assist Reprod Genet 25:535–538CrossRefPubMed

17.

Blumenfeld Z, Avivi I, Eckman A et al (2008) Gonadotropin-releasing hormone agonist decreases chemotherapy induced gonadotoxicity and premature ovarian failure in young female patients with Hodgkin lymphoma. Fertil Steril 89:166–173CrossRefPubMed

18.

Cigni A, Faedda R, Atzeni MM et al (2008) Hormonal strategies for fertility preservation in patients receiving cyclophosphamide to treat glomerulonephritis: a nonrandomized trial and review of the literature. Am J Kidney Dis 52:887–896CrossRefPubMed

19.

Ismail-Khan R, Minton S, Cox C et al (2008) Preservation of ovarian function in young women treated with neoadjuvant chemotherapy for breast cancer: a randomized trial using the GnRH agonist (triptorelin) during chemotherapy. J Clin Oncol 26:(abstr 524)

20.

Huser M, Crha I, Ventruba P et al (2008) Prevention of ovarian function damage by a GnRH analogue during chemotherapy in Hodgkin lymphoma patients. Hum Reprod 23:863–868CrossRefPubMed

21.

Badawy A, Elnashar A, El-Ashry M et al (2009) Gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage: prospective randomized study. Fertil Steril 91:694–697CrossRefPubMed

22.

Nitzschke M, Raddatz J,Bohlmann MK et al (2010) GnRH analogs do not protect ovaries from chemotherapy-induced ultrastructural injury in Hodgkin’s lymphoma patients. Arch Gynecol Obstet 282(1):83–88

23.

Sverrisdottir A, Nystedt M, Johansson H et al (2009) Adjuvant goserelin and ovarian preservation in chemotherapy treated patients with early breast cancer: results from a randomized trial. Breast Cancer Res Treat 117:561–567CrossRefPubMed

24.

Whitehead E, Shalet SM, Blackledge G et al (1983) The effect of combination chemotherapy on ovarian function in women treated for Hodgkin’s disease. Cancer 52:988–993CrossRefPubMed

25.

Longhi A, Pignotti E, Versari M et al (2003) Effect of oral contraceptive on ovarian function in young females undergoing neoadjuvant chemotherapy treatment for osteosarcoma. Oncol Rep 10:151–155PubMed

26.

Behringer K, Breuer K, Reineke T et al (2005) Secondary amenorrhea after Hodgkin’s lymphoma is influenced by age at treatment, stage of disease, chemotherapy regimen, and the use of oral contraceptives during therapy: a report from the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 23:7555–7564CrossRefPubMed

27.

Behringer K, Wildt L, Mueller H et al (2010) No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group. Ann Oncol (in press)

28.

Del Mastro L, Catzeddu T, Boni L et al (2008) Prevention of chemotherapy-induced menopause by temporary ovarian suppression with goserelin in young, early breast cancer patients. Ann Oncol 17:74–78CrossRef

29.

Franke HR, Smit WM, Vermes I (2005) Gonadal protection by a gonadotropin-releasing hormone agonist depot in young women with Hodgkin’s disease undergoing chemotherapy. Gynecol Endocrinol 20:274–278CrossRefPubMed

30.

Potolog-Nahari C, Fishman A, Cohen I (2007) Protection of ovarian function and fertility using a combination of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist during cancer treatment in young females. Gynecol Endocrinol 23:290–294CrossRefPubMed

31.

Recchia F, Saggio G, Amiconi G et al (2006) Gonadotropin-releasing hormone analogues added to adjuvant chemotherapy protect ovarian function and improve clinical outcomes in young women with early breast carcinoma. Cancer 106:514–523CrossRefPubMed

32.

Teinturier C, Hartmann O, Valteau-Couanet D et al (1998) Ovarian function after autologous bone marrow transplantation in childhood: high-dose busulfan is a major cause of ovarian failure. Bone Marrow Transplant 22:989–994CrossRefPubMed

33.

Crosignani PG, Ragni G, Lombroso GC et al (1988) Ovarian stimulation of IVF patients: effects of the reversible hypogonadotropic state induced by GnRH agonist. Hum Reprod 3:39–41PubMed

34.

Lutchman Singh K, Muttukrishna S et al (2007) Predictors of ovarian reserve in young women with breast cancer. Br J Cancer 96:1808–1816CrossRefPubMed

35.

van Beek RD, van den Heuvel-Eibrink MM, Laven JS et al (2007) Anti-Mullerian hormone is a sensitive serum marker for gonadal function in women treated for Hodgkin’s lymphoma during childhood. J Clin Endocrinol Metab 92:3869–3874CrossRefPubMed

36.

Bukman A, Heineman MJ (2001) Ovarian reserve testing and the use of prognostic models in patients with subfertility. Hum Reprod Update 7:581–590CrossRefPubMed

37.

Berlin JA, Rennie D (1999) Measuring the quality of trials: the quality of quality scales. JAMA 282:1083–1084CrossRefPubMed

38.

Henderson J, Gray R, Brocklehurst P (2007) Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG 114:243–252CrossRefPubMed

39.

Higgins JPT, Thompson SG, Deeks JJ et al (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560CrossRefPubMed

40.

Sklar CA, Mertens AC, Mitby P et al (2008) Premature menopause in survivors of childhood cancer: a report from the childhood cancer survivor study. J Natl Cancer Inst 98:890–896

41.

Matsumoto M, Miyauchi M, Yamamoto N et al (2000) Investigation of menstruation recovery after LH-RH agonist therapy for premenopausal patients with breast cancer. Breast Cancer 7:237–240CrossRefPubMed

42.

Meirow D (2000) Reproduction post-chemotherapy in young cancer patients. Mol Cell Endocrinol 169:123–131CrossRefPubMed

43.

Ataya KM, McKanna JA, Weintraub AM et al (1985) Luteinizing hormone-releasing hormone agonist for the prevention of chemotherapy-induced ovarian follicular loss in rats. Cancer Res 45:3651–3656PubMed

44.

Letterie GS (2004) Anovulation in the prevention of cytotoxic-induced follicular attrition and ovarian failure. Hum Reprod 19:831–837CrossRefPubMed

45.

Imai A, Furui T (2007) Chemotherapy-induced female infertility and protective action of gonadotropin-releasing hormone analogues. J Obstet Gynaecol 27:20–24CrossRefPubMed

46.

Danforth DR, Arbogast LK, Friedman CI (2005) Acute depletion of murine primordial follicle reserve by gonadotropin-releasing hormone antagonists. Fertil Steril 83:1333–1338CrossRefPubMed

47.

Chapman RM, Sutcliffe SB, Malpas JS (1979) Cytotoxic induced ovarian failure in women with Hodgkin’s disease. I. Hormonal function. JAMA 242:1877–1881CrossRefPubMed

48.

Meistrich ML (1994) Failure to demonstrate hormonal protection of chemotherapy-induced fertility reduction in female rats. Reprod Toxicol 8:277–278CrossRefPubMed

49.

Hsueh AJ, McGee EA, Hayashi M et al (2000) Hormonal regulation of early follicle development in the rat ovary. Mol Cell Endocrinol 163:95–100CrossRefPubMed

50.

Meistrich ML, Shetty G (2008) Hormonal suppression for fertility preservation in males and females. Reproduction 136:691–701CrossRefPubMed

51.

Meirow D, Assad G, Dor J et al (2004) The GnRH antagonist cetrorelix reduces cyclophosphamide-induced ovarian follicular destruction in mice. Hum Reprod 19:1294–1299CrossRefPubMed

52.

Gupta RK, Flaws JA (2005) Gonadotropin-releasing hormone (GnRH) analogues and the ovary: do GnRH antagonists destroy primordial follicles? Fertil Steril 83:1339–1342CrossRefPubMed

53.

Adashi EY (1994) Long-term gonadotropin-releasing hormone agonist therapy: the evolving issue of steroidal ‘add-back’ paradigms. Hum Reprod 9:1380–1397PubMed

54.

Nagy A, Schally AV (2005) Targeting of cytotoxic luteinizing hormone-releasing hormone analogs to breast, ovarian, endometrial, and prostate cancers. Biol Reprod 73:851–859CrossRefPubMed

55.

Meirow D, Rabinovici J, Katz D et al (2008) Prevention of severe menorrhagia in oncology patients with treatment-induced thrombocytopenia by luteinizing hormone-releasing hormone agonist and depo-medroxyprogesterone acetate. Cancer 1:1634–1641

56.

Quaas AM, Ginsburg ES (2007) Prevention and treatment of uterine bleeding in hematologic malignancy. Eur J Obstet Gynecol Reprod Biol 134:3–8CrossRefPubMed

57.

Porcu E, Venturoli S (2006) Progress with oocyte cryopreservation. Curr Opin Obstet Gynecol 18:273–279CrossRefPubMed

58.

Sharma R, Hamilton A, Beith J (2008) LHRH agonists for adjuvant therapy of early breast cancer in premenopausal women. Cochrane Database Syst Rev 8:CD004562

Titel: Pharmacological interventions for fertility preservation during chemotherapy: a systematic review and meta-analysis
verfasst von: Irit Ben-Aharon
Anat Gafter-Gvili
Leonard Leibovici
Salomon M. Stemmer
Publikationsdatum: 01.08.2010
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 3/2010
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-010-0996-7

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Pharmacological interventions for fertility preservation during chemotherapy: a systematic review and meta-analysis

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