Gonadal protection by a gonadotropin-releasing hormone agonist depot in young women with Hodgkin's disease undergoing chemotherapy.
OBJECTIVE
To explore the effects of a gonadotropin-releasing hormone (GnRH) agonist depot (goserelin acetate) in women with Hodgkin's disease receiving chemotherapy while taking a continuous combined estrogen-progestin preparation as add-back on the prevention of premature ovarian failure (POF).


METHODS
In a prospective pilot study, five premenopausal women with Hodgkin's disease received a GnRH agonist depot plus add-back until polychemotherapy was completed. Every 4 weeks during treatment and thereafter, a hormonal profile (follicle-stimulating hormone (FSH), luteinizing hormone, 17beta-estradiol, progesterone and inhibin B) was measured until resumption of menstruation or the development of a hypergonadotropic state (2 x FSH > 30 U/l).


RESULTS
All patients reached prepubertal status during treatment. After discontinuation of goserelin acetate, one patient developed a hypergonadotropic state and four patients resumed menstruation. One of those patients became pregnant and delivered a healthy son.


CONCLUSIONS
The effectiveness of GnRH agonist plus add-back on the prevention of POF during polychemotherapy in women with Hodgkin's disease needs further elucidation in randomized controlled trials. The results of our pilot study are promising.
Franke
Henk R
HR
Department of Obstetrics and Gynecology, Medisch Spectrum Twente Hospital Group, PO Box 50000, 7500 KA Enschede, The Netherlands. hfranke@xs4all.nl
Smit
Wim M
WM
Vermes
Istvan
I
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D017273:Goserelin / Q000008:administration & dosage*; D006689:Hodgkin Disease / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007265:Inhibins / Q000097:blood; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077563:Norethindrone Acetate; D010865:Pilot Projects; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; C422364:inhibin B; D017273:Goserelin; D004958:Estradiol; D007265:Inhibins; D005640:Follicle Stimulating Hormone; D000077563:Norethindrone Acetate; D009640:Norethindrone