title: Goserelin with chemotherapy to preserve ovarian function in pre-menopausal women with early breast cancer: menstruation and pregnancy outcomes.
abstract: BACKGROUND
  Premature ovarian failure and infertility following chemotherapy in early breast cancer (EBC) are major concerns for young women. The role of gonadotrophin-releasing hormone (GnRH) agonists with chemotherapy in EBC in reducing the incidence of chemotherapy-induced early menopause remains uncertain, and long-term data on the recovery of fertility are sparse. We report an audit of our experience with the GnRH agonist, goserelin (Zoladex®), used with chemotherapy to preserve ovarian function and maintain fertility.
  
  
  METHODS
  Pre-menopausal women were given goserelin subcutaneously every 28 days during chemotherapy, starting 0-14 days before treatment. The main clinical end point was recovery of menstruation after chemotherapy. The other end points were rate of successful conception and median time to recovery of menses.
  
  
  RESULTS
  About 84% of 125 women recovered menstruation with the median time to recovery of 6 months (1-43 months), including 76% of 71 patients aged over 35. Of the 42 patients who attempted pregnancy, 71% (n=30) managed to achieve pregnancies. At the time of analysis, there were 42 pregnancies and 30 healthy deliveries.
  
  
  CONCLUSIONS
  The GnRH agonist, goserelin, given with chemotherapy for EBC is associated with a low risk of long-term chemotherapy-induced amenorrhoea and a high chance of pregnancy. Further randomised trials are needed.
authors.affiliation: Department of Medicine, Breast Unit, Royal Marsden Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Wong
authors.forename: S
authors.initials: S
authors.lastname: O'Neill
authors.forename: G
authors.initials: G
authors.lastname: Walsh
authors.forename: I E
authors.initials: IE
authors.lastname: Smith
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D008598:Menstruation; D008875:Middle Aged; D010053:Ovary / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D017697:Premenopause
chemical_list: D017273:Goserelin