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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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Forest plots showing POF rate of eligible studies comparing GnRH agonists plus chemotherapy with chemotherapy alone.
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pone-0080444-g002: Forest plots showing POF rate of eligible studies comparing GnRH agonists plus chemotherapy with chemotherapy alone.

Mentions: 6 of 7 included articles evaluated POF rate in the last follow-up after cessation of treatment. A substantial heterogeneity was suggested by results of the Q test (P=0.0009) and the I2 index (I2 Value= 76%). Considering the heterogeneity, we performed the random effect model which showed the incidence of women with POF demonstrated a statistically significant difference in favor of the use of GnRHa (OR=0.32, 95% CI 0.13-0.77). (Figure 2)


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)

Forest plots showing POF rate of eligible studies comparing GnRH agonists plus chemotherapy with chemotherapy alone.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0080444-g002: Forest plots showing POF rate of eligible studies comparing GnRH agonists plus chemotherapy with chemotherapy alone.
Mentions: 6 of 7 included articles evaluated POF rate in the last follow-up after cessation of treatment. A substantial heterogeneity was suggested by results of the Q test (P=0.0009) and the I2 index (I2 Value= 76%). Considering the heterogeneity, we performed the random effect model which showed the incidence of women with POF demonstrated a statistically significant difference in favor of the use of GnRHa (OR=0.32, 95% CI 0.13-0.77). (Figure 2)

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