GnRH-agonists in fertility preservation.

Area of Science:

• Reproductive Endocrinology
• Oncology
• Pharmacology

Background:

• Chemotherapy poses a significant risk of gonadotoxicity, leading to fertility loss and premature ovarian failure.
• Fertility preservation is a critical concern for women of reproductive age undergoing cancer treatment.
• Current fertility preservation methods include assisted reproductive technologies and cryopreservation, with ongoing research into novel approaches.

Purpose of the Study:

• To review recent advancements in fertility preservation strategies utilizing gonadotropin-releasing hormone agonists (GnRH-a) during gonadotoxic chemotherapy.
• To evaluate the efficacy of GnRH-a in mitigating chemotherapy-induced ovarian damage.

Main Methods:

• Review of existing literature and clinical studies on GnRH-a use in fertility preservation.
• Analysis of data from hematologic diseases (e.g., Hodgkin lymphoma) and breast cancer patients.
• Examination of GnRH-a effects in nonmalignant autoimmune diseases (e.g., systemic lupus erythematosus).

Main Results:

• GnRH-a cotreatment demonstrated a beneficial effect in minimizing chemotherapy-associated gonadotoxicity in hematologic malignancies and breast cancer.
• GnRH-a prevented premature ovarian failure in patients with autoimmune diseases treated with cyclophosphamide.
• GnRH-a was more effective than gestagens in preventing menometrorrhagia during chemotherapy-induced thrombocytopenia.

Conclusions:

• GnRH-a cotreatment appears to effectively minimize ovarian damage during gonadotoxic chemotherapy.
• Further prospective randomized studies are needed to confirm these findings in larger patient cohorts.
• GnRH-a cotreatment may be considered a routine clinical option for women of reproductive age undergoing gonadotoxic chemotherapy, complementing existing fertility preservation methods.