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Use of Hormonal Protection for Chemotherapy-induced Gonadotoxicity

KIM, S. SAMUEL MD, FACOG*; LEE, JUNG RYEOL MD; JEE, BYUNG CHUL MD, PhD† ‡; SUH, CHANG SUK MD, PhD† ‡; KIM, SEOK HYUN MD, PhD; TING, ALISON PhD§; PETROFF, BRIAN PhD

Clinical Obstetrics & Gynecology: December 2010 - Volume 53 - Issue 4 - pp 740-752
doi: 10.1097/GRF.0b013e3181f96cb1
Fertility Preservation: New Developments

It is still controversial that GnRH agonist (GnRHa) protects ovarian function from chemotherapy-induced gonadotoxicity. Indeed, the results of many studies related to this issue are neither consistent nor convincing because of the weak study design and the inadequate sample size. We identified 11 prospective controlled studies (8 nonrandomized and 3 randomized) for the systemic review and meta-analysis. The meta-analysis showed that GnRHa cotreatment during chemotherapy can protect ovarian function. However, it is worthy to note that the result of this meta-analysis is influenced by nonrandomized studies. The protective effect of GnRHa will remain elusive until the currently ongoing large, prospective, randomized studies are completed. In addition, tamoxifen, a selective estrogen receptor modulator, may have the protective effect against loss of follicles and ovarian function, which was caused by chemotherapy.

Departments of *Obstetrics and Gynecology

Internal Medicine, University of Kansas School of Medicine

Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital

Department of Obstetrics and Gynecology, Seoul National University College of Medicine

§Department of Reproductive Sciences, Oregon National Primate Research Center, Portland, Oregon

Correspondence: S. Samuel Kim, MD, FACOG, Department of Obstetrics and Gynecology, University of Kansas School of Medicine, 3901 Rainbow Blvd., Kansas City, KS. E-mail: skim2@kumc.edu

© 2010 Lippincott Williams & Wilkins, Inc.