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GnRH analogue failed to preserve post-treatment ovarian function

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ASRM 67th Annual Meeting

New data indicate that administration of a gonadotropin-releasing hormone analogue did not maintain ovarian function in women at risk for developing ovarian insufficiency related to breast cancer treatment.

Researchers at the Zagazig University School of Medicine and the Alexandria Regional Center for Women Health and Development in Egypt conducted a multicenter trial to evaluate the potential benefit of gonadotropin-releasing hormone (GnRH) in 100 women aged 18 to 37 years who were to receive cyclophosphamide-based chemotherapy for breast cancer. The researchers randomly assigned women who were to initiate treatment 4 to 7 days after presentation to immediately receive a GnRH-agonist or a GnRH-antagonist followed 3 days later by a 7-day course of chemotherapy (Arm I) or chemotherapy with placebo (Arm II). The researchers also randomly assigned women who were to begin treatment at least 10 days after presentation to immediately receive a GnRH-agonist followed 10 to 14 days later by chemotherapy (Arm III) or chemotherapy plus placebo (Arm IV). Administration of GnRH continued throughout treatment.

Results revealed that menses resumed for 64% of patients in Arm I compared with 72% of patients in Arm II at 6 month (P>.05). At 12 months, 80% of patients in each group had resumed menses, according to the researchers. For patients who received later treatment, menses resumed for 68% of patients at 6 months and 84% at 12 months in Arm III compared with 76% and 80% in Arm IV (P>.05). The researchers noted no statistically significant differences in hormonal levels between Arms I and II or Arms III and IV at either time point (P>.05).

“GnRH analogue administration before and during cyclophosphamide-based chemotherapy for young women with breast cancer does not appear to preserve post-treatment ovarian function,” the researchers wrote.

For more information:

• Elgindy EA. O-158. Presented at: the American Society for Reproductive Medicine 67th Annual Meeting; Oct. 15-19, 2011; Orlando, Fla.

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