GnRH-Analogues for Ovarian Protection in Childhood Cancer Patients: How Adult Hypotheses are Relevant in Prepubertal Females

Abstract

Systemic chemotherapy frequently causes primary ovarian insufficiency. In prepubertal girls, currently the only option to preserve ovarian function is ovarian tissue preservation. The use of gonadotropin-releasing hormone analogues given in combination with chemotherapy has been studied in reproductive age women. The exact mechanism is unknown, but some of the proposed protective mechanisms could theoretically protect the prepubertal ovary as it has been theorized in many of the studies on reproductive age women. None of the studies implies an adverse affect of GnRH analogue administration in terms of worsening health or cancer status. As 83% of children diagnosed with cancer will survive into adulthood, GnRH analogue administration to female childhood cancer patients in combination with chemotherapy might represent a valuable attempt to preserve future ovarian function and fertility when ovarian tissue preservation is not an option.