GnRH-agonists in fertility preservation.
OBJECTIVE
Description of the recent progress in fertility preservation despite gonadotoxic chemotherapy, using gonadotropin-releasing hormone (GnRH)-agonists (GnRH-a).


RESULTS
Most groups of investigators have found a beneficial effect of the administered GnRH-a on minimizing the chemotherapy-associated gonadotoxic effect, in both hematologic diseases, mainly Hodgkin lymphoma and in young breast cancer patients. The GnRH-a cotreatment may also prevent premature ovarian failure in patients with nonmalignant, autoimmune diseases, such as systemic lupus erythematosus, exposed to cyclophosphamide pulsatile therapy. Moreover, GnRH-a coadministration proved to prevent the menometrorrhagia of young women during chemotherapy-induced thrombocytopenia more effectively than gestagens.


CONCLUSIONS
GnRH-a cotreatment appears to minimize ovarian damage. If these preliminary results are consistent in a larger group of patients and proven in a prospective randomized study, the GnRH-a cotreatment should be considered as a clinical routine in every woman in the reproductive age exposed to gonadotoxic chemotherapy, in addition to assisted reproductive technology, and to the investigational attempts of ova, follicles, or ovarian cryopreservation for future in-vitro maturation of primordial follicles, and ovarian autotransplantation or xenotransplantation.
Blumenfeld
Zeev
Z
Department of Obstetrics and Gynecology, Rambam Health Care Campus, The Rappaport Family Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. bzeev@techunix.technion.ac.il
D000818:Animals; D001327:Autoimmune Diseases / Q000188:drug therapy; D001943:Breast Neoplasms / Q000188:drug therapy; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000627:therapeutic use*; D006066:Gonads / Q000187:drug effects / Q000503:physiopathology; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D007246:Infertility / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000517:prevention & control
D007987:Gonadotropin-Releasing Hormone