Protection of ovarian function by GnRH agonists during chemotherapy: a meta-analysis

This meta-analysis was designed to assess the overall performance of GnRHa in preserving the ovarian function in young women undergoing chemotherapy. Electronic literature databases including Pubmed, MEDLINE, Cochrane library, Embase, CNKI and Wanfang were searched for articles published till November, 2013. The articles written in both Chinese and English were considered. Only randomized controlled trials (RCTs) were selected. Main Outcome Measure was evaluated by assessing the post‑chemotherapy ovarian function. A random-effects model was used to calculate the risk ratio (RR) and associated 95% confidence intervals (95% CI). Out of the eight RCTs including 621 patients, 321 women were treated with GnRHa during chemotherapy, 9.66% of whom suffered premature ovarian failure (POF). On the other hand, 26.67% of the remaining 300 women suffered POF. More women treated without GnRHa experienced post-chemotherapy POF, yielding an RR of 0.45 [chemotherapy plus GnRHa vs. chemotherapy alone, 95% confidence interval (CI) (0.22, 0.92)]. Based on the available studies, GnRHa plays an important role in the prevention of post-chemotherapy POF, but does not exhibit its protective effects in fertility.