The Journal of Korean Society of Menopause  2013;19(2):93-100

doi:10.6118/jksm.2013.19.2.93

GnRH Agonist Co-treatment for Prevention of Primary Ovarian Insufficiency in Patients with Hematologic Malignancies Undergoing Chemotherapy.

Sungwook CHUN 1 ; Yong Il JI ; Young Don JOO

Affiliations

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Keywords

Anti-mullerian hormone; Chemotherapy; GnRH agonist; Hematologic neoplasms; Primary ovarian insufficiency

Country

Republic of Korea

Language

Korean

Abstract

OBJECTIVES: The aim of this study was to assess the effect of gonadotropin-releasing hormone (GnRH) agonist co-treatment for gonadal protection in patients with hematologic neoplasms undergoing chemotherapy. METHODS: Young premenopausal women who were diagnosed with leukemia or lymphoma between March 2010 and February 2012 and undergoing chemotherapy in a university hospital were included in this study. RESULTS: Twenty-nine patients aged 15.39 years participated in this study. Among the patients, five patients were receiving leuprolide concomitant with chemotherapy, and twenty-four patients were receiving chemotherapy alone. Seventeen patients in the chemotherapy alone group stopped menstrating and were diagnosed with primary ovarian insufficiency (POI) within one year after chemotherapy; and only one patient had POI in the chemotherapy plus leuprolide group, but these differences were not statistically significant (P = 0.054). In the chemotherapy plus leuprolide group, serum anti-mullerian hormone (AMH) levels were significantly lower than basal serum AMH levels (5.57 +/- 0.18 ng/mL) (P < 0.001) after treatment (1.84 +/- 0.22 ng/mL). CONCLUSION: GnRH agonist may be a promising option for the prevention of POF, but the effectiveness of GnRH agonist is still debatable. A large prospective multi-center trial with adequate follow-up is needed.