title: 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.
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.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  University-based hospitals.
  
  
  METHODS
  Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen.
  
  
  METHODS
  Randomization to concurrent GnRH agonists with chemotherapy or chemotherapy alone.
  
  
  METHODS
  Odds ratio (OR) of resumption of menses 1 year or more after chemotherapy.
  
  
  RESULTS
  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 (I2=16.6%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division 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.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Vitek
authors.affiliation: Department of Hematology and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors.forename: Michelle
authors.initials: M
authors.lastname: Shayne
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hoeger
authors.affiliation: Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.
authors.forename: Yu
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York.
authors.forename: Susan
authors.initials: S
authors.lastname: Messing
authors.affiliation: Department of Hematology and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors.forename: Chunkit
authors.initials: C
authors.lastname: Fung
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D059247:Fertility Preservation / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D010053:Ovary / Q000187:drug effects* / Q000502:physiology; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D013629:Tamoxifen / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D013629:Tamoxifen; D007987:Gonadotropin-Releasing Hormone
keywords: GnRH agonist; breast cancer; fertility preservation; meta-analysis; systematic review