Gonadotropin-releasing hormone agonists for the protection of ovarian function in premenopausal patients treated by chemotherapy: a meta-analysis

Abstract

Objective To evaluate systematically the effectiveness of gonadotropin-releasing hormone agonist (GnRHa) administration before chemotherapy and/or during chemotherapy for the protection of ovarian function in premenopausal women. Methods PubMed, Cochrane Library, Medline, Embase, China Biomedical Literature Database, CNKI were searched to collect the clinical randomized control trail (RCT) of ovarian function protection in premenopausal women receiving chemotherapy by using GnRHa. RevMan5.3 software was used to analyze the incidence of early premature ovarian insufficiency (POI), menstrual recovery rate, pregnancy rate and other indicators. Results A total of 12 articles were included, including a total of 1 509 premenopausal women who received chemotherapy for malignant diseases. GnRHa combined with chemotherapy reduced the incidence of POI (OR = 0.36, 95% CI 0.23-0.56, P < 0.01) and improved the menstrual recovery rate during follow-up (OR = 2.49, 95% CI 1.72-3.60, P < 0.01). GnRHa combined with chemotherapy could increase the pregnancy rate of patients aged 35 years and older (OR = 2.04, 95% CI 1.08-3.83, P = 0.03). Conclusion GnRHa administration before chemotherapy and/or during chemotherapy may prevent the chemotherapy damage to ovarian function, reduce the incidence of POI, and improve the recovery rate of menstruation. Key words: Ovarian function protection; Gonadotropin-releasing hormone agonist; Drug therapy; Premature ovarian insufficiency; Meta-analysis