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Gonadotropin-releasing hormone for preservation of ovarian function during chemotherapy in lymphoma patients of reproductive age: a summary based on 434 patients.

Zhang Y, Xiao Z, Wang Y, Luo S, Li X, Li S - PLoS ONE (2013)

Bottom Line: However, studies of its clinical efficacy have reported conflicting results.In addition, the final level of FSH in the GnRH group was significantly lower than control group. (MD= -11.73, 95% CI,-22.25- -1.20), and the final level of AMH in the GnRH group was significantly higher than control group (MD=0.80; 95% CI, 0.61-0.98).However, there was no statistically significant difference between treatment and the control groups in the incidence of a spontaneous pregnancy (OR=1.11; 95% CI, 0.55-2.26).

View Article: PubMed Central - PubMed

Affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.

ABSTRACT

Background: Gonadotropin-releasing hormone agonists (GnRHa) might play a role in preserving ovarian function in lymphoma patients by inhibiting chemotherapy-induced ovarian follicular damage. However, studies of its clinical efficacy have reported conflicting results.

Method: We conducted a meta-analysis to determine the effect of the preservation of ovarian function by administering GnRHa in young patients with lymphoma undergoing chemotherapy. Seven studies were identified that met inclusion criteria and comprised 434 patients assigned to GnRHa combined chemotherapy or chemotherapy alone.

Results: The incidence of women with premature ovarian failure (POF) demonstrated a statistically significant difference in favor of the use of GnRHa (OR=0.32, 95% CI 0.13-0.77). In addition, the final level of FSH in the GnRH group was significantly lower than control group. (MD= -11.73, 95% CI,-22.25- -1.20), and the final level of AMH in the GnRH group was significantly higher than control group (MD=0.80; 95% CI, 0.61-0.98). However, there was no statistically significant difference between treatment and the control groups in the incidence of a spontaneous pregnancy (OR=1.11; 95% CI, 0.55-2.26).

Conclusion: This meta-analysis suggests that GnRHa may be effective in protecting ovarian function during chemotherapy in lymphoma patients. More well-designed prospective studies are needed to carry out for further understanding of this topic.

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Related in: MedlinePlus

Flow diagram for selection of the studies.
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pone-0080444-g001: Flow diagram for selection of the studies.

Mentions: The literature search yielded 257 citations. Of these, 240 were excluded after reading the title and the abstract. Full text versions of 17 articles were obtained. After full-text review, 10 studies were excluded due to differing grouping condition or repetitive data. Therefore, of these 17 articles, 7 were included in the completed review (Figure 1, Table 1)[7-13]. These studies represented a total of 434 patients with GnRHa combined chemotherapy or chemotherapy alone. Three studies were prospectively randomized studies including 130 patients (67 in the study group and 63 in the control group)[7,12,13]. Four studies were case series with control including 304 patients (177 in the study group and 127 in the control group)[8-11]. Characteristics of the included studies are listed in Table 1.


Gonadotropin-releasing hormone for preservation of ovarian function during chemotherapy in lymphoma patients of reproductive age: a summary based on 434 patients.

Zhang Y, Xiao Z, Wang Y, Luo S, Li X, Li S - PLoS ONE (2013)

Flow diagram for selection of the studies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3842920&req=5

pone-0080444-g001: Flow diagram for selection of the studies.
Mentions: The literature search yielded 257 citations. Of these, 240 were excluded after reading the title and the abstract. Full text versions of 17 articles were obtained. After full-text review, 10 studies were excluded due to differing grouping condition or repetitive data. Therefore, of these 17 articles, 7 were included in the completed review (Figure 1, Table 1)[7-13]. These studies represented a total of 434 patients with GnRHa combined chemotherapy or chemotherapy alone. Three studies were prospectively randomized studies including 130 patients (67 in the study group and 63 in the control group)[7,12,13]. Four studies were case series with control including 304 patients (177 in the study group and 127 in the control group)[8-11]. Characteristics of the included studies are listed in Table 1.

Bottom Line: However, studies of its clinical efficacy have reported conflicting results.In addition, the final level of FSH in the GnRH group was significantly lower than control group. (MD= -11.73, 95% CI,-22.25- -1.20), and the final level of AMH in the GnRH group was significantly higher than control group (MD=0.80; 95% CI, 0.61-0.98).However, there was no statistically significant difference between treatment and the control groups in the incidence of a spontaneous pregnancy (OR=1.11; 95% CI, 0.55-2.26).

View Article: PubMed Central - PubMed

Affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.

ABSTRACT

Background: Gonadotropin-releasing hormone agonists (GnRHa) might play a role in preserving ovarian function in lymphoma patients by inhibiting chemotherapy-induced ovarian follicular damage. However, studies of its clinical efficacy have reported conflicting results.

Method: We conducted a meta-analysis to determine the effect of the preservation of ovarian function by administering GnRHa in young patients with lymphoma undergoing chemotherapy. Seven studies were identified that met inclusion criteria and comprised 434 patients assigned to GnRHa combined chemotherapy or chemotherapy alone.

Results: The incidence of women with premature ovarian failure (POF) demonstrated a statistically significant difference in favor of the use of GnRHa (OR=0.32, 95% CI 0.13-0.77). In addition, the final level of FSH in the GnRH group was significantly lower than control group. (MD= -11.73, 95% CI,-22.25- -1.20), and the final level of AMH in the GnRH group was significantly higher than control group (MD=0.80; 95% CI, 0.61-0.98). However, there was no statistically significant difference between treatment and the control groups in the incidence of a spontaneous pregnancy (OR=1.11; 95% CI, 0.55-2.26).

Conclusion: This meta-analysis suggests that GnRHa may be effective in protecting ovarian function during chemotherapy in lymphoma patients. More well-designed prospective studies are needed to carry out for further understanding of this topic.

Show MeSH
Related in: MedlinePlus