scholarly journals The use of GnRH analogs in preserving ovarian function during chemotherapy

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Omar M. Odeh ◽  
Johnny Awwad ◽  
Dalia Khalife ◽  
Suleiman Ghunaim
Keyword(s):  
Ovarian Function ◽  
Gonadotropin Releasing Hormone ◽  
Main Body ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Short Term ◽  
Releasing Hormone ◽  
Term Benefit

Abstract Background The literature has always been controversial on the use of gonadotropin-releasing hormone agonists in preserving fertility in women of childbearing age after chemotherapy; thereby, in this article, we will be discussing its use in preserving fertility. Main body of abstract When it comes to preserving fertility, it is crucial to consider all available options in this topic due to its very sensitive nature, thereby we have found that while a lot of trials favor the use of gonadotropin-releasing hormone agonists, the lack of proper follow-up and long-term trials renders its use highly debatable, and since the longest follow-up trial showed non-significant results, it also opens the floor for debate on whether this short-term benefit is worth adding another drug to the regimen or not. Short conclusion As described in this review, while the use of gonadotropin-releasing hormone agonists is beneficial in a lot of studies, the lack of long-term reports still makes its use debatable, thereby more trials should be done.

No Evidence for the Benefit of Gonadotropin-Releasing Hormone Agonist in Preserving Ovarian Function and Fertility in Lymphoma Survivors Treated With Chemotherapy: Final Long-Term Report of a Prospective Randomized Trial

2016 ◽  
Vol 34 (22) ◽  
pp. 2568-2574 ◽  
Author(s):  
Isabelle Demeestere ◽  
Pauline Brice ◽  
Fedro A. Peccatori ◽  
Alain Kentos ◽  
Jehan Dupuis ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Function ◽  
Follicle Stimulating Hormone ◽  
Gonadotropin Releasing Hormone ◽  
Control Group ◽  
Releasing Hormone ◽  
Gonadotropin Releasing Hormone Agonist ◽  
Stimulating Hormone

Purpose We have reported previously that after 1-year follow up, gonadotropin-releasing hormone agonist (GnRHa) did not prevent chemotherapy-induced premature ovarian failure (POF) in patients with lymphoma, but may provide protection of the ovarian reserve. Here, we report the final analysis of the cohort after 5 years of follow up. Patients and Methods A total of 129 patients with lymphoma were randomly assigned to receive either triptorelin plus norethisterone (GnRHa group) or norethisterone alone (control group) during chemotherapy. Ovarian function and fertility were reported after 2, 3, 4, and 5 to 7 years of follow up. The primary end point was POF, defined as at least one follicle-stimulating hormone value of > 40 IU/L after 2 years of follow up. Results Sixty-seven patients 26.21 ± 0.64 years of age had available data after a median follow-up time of 5.33 years in the GnRHa group and 5.58 years in the control group (P = .452). Multivariate logistic regression analysis showed a significantly increased risk of POF in patients according to age (P = .047), the conditioning regimen for hematopoietic stem cell transplant (P = .002), and the cumulative dose of cyclophosphamide > 5 g/m2 (P = .019), but not to the coadministration of GnRHa during chemotherapy (odds ratio, 0.702; P = .651). The ovarian reserve, evaluated using anti-Müllerian hormone and follicle-stimulating hormone levels, was similar in both groups. Fifty-three percent and 43% achieved pregnancy in the GnRHa and control groups, respectively (P = .467). Conclusion To the best of our knowledge, this is the first long-term analysis confirming that GnRHa is not efficient in preventing chemotherapy-induced POF in young patients with lymphoma and did not influence future pregnancy rate. These results reopen the debate about the drug’s benefit in that it should not be recommended as standard for fertility preservation in patients with lymphoma.

Gonadotropin-Releasing Hormone Agonist for the Prevention of Chemotherapy-Induced Ovarian Failure in Patients With Lymphoma: 1-Year Follow-Up of a Prospective Randomized Trial

2013 ◽  
Vol 31 (7) ◽  
pp. 903-909 ◽  
Author(s):  
Isabelle Demeestere ◽  
Pauline Brice ◽  
Fedro A. Peccatori ◽  
Alain Kentos ◽  
Isabelle Gaillard ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Alkylating Agents ◽  
Prospective Trial ◽  
Young Patients ◽  
Ovarian Failure ◽  
Gonadotropin Releasing Hormone ◽  
Control Group ◽  
Releasing Hormone ◽  
Gonadotropin Releasing Hormone Agonist

Purpose To assess the efficacy of gonadotropin-releasing hormone agonist (GnRHa) in preventing chemotherapy-induced ovarian failure in patients treated for Hodgkin or non-Hodgkin lymphoma within the setting of a multicenter, randomized, prospective trial. Patients and Methods Patients age 18 to 45 years were randomly assigned to receive either the GnRHa triptorelin plus norethisterone (GnRHa group) or norethisterone alone (control group) concomitantly with alkylating agents containing chemotherapy. The primary end point was the premature ovarian failure (POF) rate (follicle-stimulating hormone [FSH] ≥ 40 IU/L) after 1 year of follow-up. Results Eighty-four of 129 randomly assigned patients completed the 1-year follow-up. The mean FSH values were higher in the control group than in the GnRHa group during chemotherapy; however, this difference was no longer observed after 6 months of follow-up. After 1 year, 20% and 19% of patients in the GnRHa and control groups, respectively, exhibited POF (P = 1.00). More than half of patients in each group completely restored their ovarian function (FSH < 10 IU/L), but the anti–Müllerian hormone values were higher in the GnRHa group than in the control group (1.4 ± 0.35 v 0.5 ± 0.15 ng/mL, respectively; P = .040). The occurrence of adverse events was similar in both groups with the exception of metrorrhagia, which was more frequently observed in the control group than the GnRHa group (38.4% v 15.6%, respectively; P = .024). Conclusion Approximately 20% of patients in both groups exhibited POF after 1 year of follow-up. Triptorelin was not associated with a significant decreased risk of POF in young patients treated for lymphoma but may provide protection of the ovarian reserve.

scholarly journals Peningkatan Kesadaran Masyarakat dalam Penggunaan Alat Kontrasepsi di Kelurahan Kenali Asam Bawah

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Safitri Safitri
Keyword(s):  
Health Education ◽  
Surgical Procedures ◽  
Health Workers ◽  
Sexual Practices ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Short Term ◽  
Before And After ◽  
Effective Contraception

Contraception is defined as the intentional prevention of conception through the use of various devices, sexual practices, chemicals, drugs, or surgical procedures. Contraceptive is device or act whose purpose is to prevent a woman from becoming pregnant. The choice of contraception in Kelurahan Kenali Asam Bawah is dominated by short-term contraception methods (injections and pills by 88%). In addition, there are still couples of childbearing age who do not use contraception by 22.2% on the grounds of not knowing 17.5%, 61.7% uncomfortable, religiously prohibited 16.7% and expensive 4.1%. Health education by trained health workers can increase knowledge and encourage fertile age couples to make decisions in using appropriate and effective contraception. Target outcomes expected are: there is an increased knowledge between before and after counseling, as well as awareness to use contraception. The method used is counseling. The results of dedication are an increase in knowledge of women of childbearing age and awareness to use safer contraceptives, so that community coverage related to long-term contraception is increased.

scholarly journals A retrospective, observational, single center study of gonadotropin-releasing hormone agonist protocols at the Reproductive Center of Farah Hospital in Jordan

2019 ◽  
Vol 7 (8) ◽  
pp. 3103
Author(s):  
Zaid Kilani ◽  
Mohammad Shaban
Keyword(s):  
Term Treatment ◽  
Gonadotropin Releasing Hormone ◽  
Clinical Pregnancy ◽  
Short Term ◽  
Short Term Treatment ◽  
Releasing Hormone ◽  
Long Term Treatment ◽  
Group A

Background: Data on infertility and in vitro fertilization (IVF) are incomplete and uncertain in Jordan and worldwide because of difficulties in evaluating infertility in the general population. This study aimed at comparing the effectiveness of the gonadotropin-releasing hormone agonists (GnRH-a) long and short protocols as part of IVF or intracytoplasmic sperm injection.Methods: This observational, retrospective, comparative, longitudinal study was conducted in a reproductive center in Jordan. It reviewed data charts from women who took GnRH-a for IVF, from 2010 to 2013. These were categorized in Group A (long-term GnRH-a: single 3.75 mg-monthly injection) or Group B (short-term GnRH-a: multiple daily 0.1 mg injections). The primary endpoint was the rate of ongoing clinical pregnancy (number of pregnancies/number of women) and live birth rate in fresh cycle/protocols.Results: Out of 1,946 eligible women, 471 underwent the long-term treatment of GnRH-a administration and 1,523 the short-term treatment. The women’s mean age was 29.61±3.80 years old. Out of the 471 women in Group A, 216 (45.9%) women had ongoing clinical pregnancy, of whom 69 (31.9%) had live births. In the short-protocol group, 485 (31.8%) women had ongoing clinical pregnancy, of whom 133 (27.4%) had live births.Conclusions: GnRH-a long protocol is more effective than the short protocol regardless of the agonist formulation used in subfertile women/men who underwent IVF/ intracytoplasmic sperm injection.

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