title: Ovarian protection with goserelin during adjuvant chemotherapy for pre-menopausal women with early breast cancer (EBC).
abstract: OBJECTIVE
  Ovarian failure and infertility following adjuvant chemotherapy for early breast cancer are major concerns for some young women. Techniques for oocyte harvesting are associated with delay in starting treatment, potentially undesirable estrogen stimulation and a relatively low success rate. We report an audit of our experience with the luteinising hormone-releasing hormone agonist, goserelin, to achieve transient ovarian suppression during chemotherapy as a means of preserving ovarian function.
  
  
  METHODS
  Pre-menopausal women were offered goserelin 3.6 mg by subcutaneous injection every 28 days during chemotherapy, starting 0-14 days prior to treatment. The primary end-point was recovery of menstruation. Serum luteinising hormone, follicle stimulating hormone and oestradiol were measured at recovery of menstruation or at first year follow-up if amenorrhoea persisted. Subsequent pregnancies were recorded.
  
  
  RESULTS
  Fifty-one evaluable women were audited. Amenorrhoea occurred in all but one. All received combination anthracycline-containing chemotherapy regimens with a mean cumulative cyclophosphamide dose of 3.9 g/m(2). Forty-five (90%) recovered menstruation during the first year of follow-up; mean time to recovery 5 months. Eight pregnancies in 10 women attempting this so far.
  
  
  CONCLUSIONS
  Using goserelin concurrently with chemotherapy is associated with a high rate of ovarian function preservation.
authors.affiliation: Institut Catala d'Oncologia, Hospital Duran i Reynalds, Gran Via km 2.7. L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ander
authors.initials: A
authors.lastname: Urruticoechea
authors.forename: Monica
authors.initials: M
authors.lastname: Arnedos
authors.forename: Geraldine
authors.initials: G
authors.lastname: Walsh
authors.forename: Mitch
authors.initials: M
authors.lastname: Dowsett
authors.forename: Ian E
authors.initials: IE
authors.lastname: Smith
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005298:Fertility / Q000187:drug effects; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D010053:Ovary / Q000187:drug effects*; D017697:Premenopause; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin