Gonadal protection by a gonadotropin-releasing hormone agonist depot in young women with Hodgkin's disease undergoing chemotherapy

Henk R. Franke, H. Franke, Wim M Smit, W. M. Smit, I⋅tvan Vermes
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2005 · vol. 20(5) , pp. 274–278 · doi:10.1080/09513590400027414 · PMID:16019373 · W2160028083
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A GnRH agonist depot with add-back therapy protected ovarian function in young women with Hodgkin's disease undergoing chemotherapy, with most resuming menstruation and one achieving pregnancy.

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Abstract

OBJECTIVE: To explore the effects of a gonadotropin-releasing hormone (GnRH) agonist depot (goserelin acetate) in women with Hodgkin's disease receiving chemotherapy while taking a continuous combined estrogen-progestin preparation as add-back on the prevention of premature ovarian failure (POF). METHODS: In a prospective pilot study, five premenopausal women with Hodgkin's disease received a GnRH agonist depot plus add-back until polychemotherapy was completed. Every 4 weeks during treatment and thereafter, a hormonal profile (follicle-stimulating hormone (FSH), luteinizing hormone, 17beta-estradiol, progesterone and inhibin B) was measured until resumption of menstruation or the development of a hypergonadotropic state (2 x FSH > 30 U/l). RESULTS: All patients reached prepubertal status during treatment. After discontinuation of goserelin acetate, one patient developed a hypergonadotropic state and four patients resumed menstruation. One of those patients became pregnant and delivered a healthy son. CONCLUSIONS: The effectiveness of GnRH agonist plus add-back on the prevention of POF during polychemotherapy in women with Hodgkin's disease needs further elucidation in randomized controlled trials. The results of our pilot study are promising.

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