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Fertil Steril. 2014 Sep;102(3):808-815.e1. doi: 10.1016/j.fertnstert.2014.06.003. Epub 2014 Jul 17.

Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis.

Author information

  • 1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York. Electronic address: wendy_vitek@urmc.rochester.edu.
  • 2Department of Hematology and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
  • 3Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
  • 4Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.

Abstract

OBJECTIVE:

To determine whether concurrent use of GnRH agonists with chemotherapy preserves ovarian function in women with breast cancer who did not use tamoxifen.

DESIGN:

Systematic review and meta-analysis.

SETTING:

University-based hospitals.

PATIENT(S):

Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen.

INTERVENTION(S):

Randomization to concurrent GnRH agonists with chemotherapy or chemotherapy alone.

MAIN OUTCOME MEASURE(S):

Odds ratio (OR) of resumption of menses 1 year or more after chemotherapy.

RESULT(S):

Searches were conducted in PubMed, Scopus, Cochrane Trials Register, and the National Research Register through March 2014, and all randomized trials that reported resumption of menses 1 year or more after GnRH agonist with chemotherapy or chemotherapy alone among women with breast cancer who did not receive tamoxifen were included. Four studies were analyzed in the meta-analysis and included 252 patients (GnRH agonist with chemotherapy, n = 131; chemotherapy alone, n = 121). There was no significant difference in the rate of return of menses between the two groups (OR, 1.47; 95% confidence interval [0.60-3.62]). Heterogeneity among the trials was not significant (I(2) = 16.6%).

CONCLUSION(S):

Concurrent GnRH agonists with chemotherapy may not preserve ovarian function in women with breast cancer. Furthermore, randomized data are limited regarding fertility after concurrent use of GnRH agonists with chemotherapy.

Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

GnRH agonist; breast cancer; fertility preservation; meta-analysis; systematic review

PMID:
25044080
[PubMed - in process]
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