How Does GnRHa work? |
Data is limited about the efficacy of GnRHa to prevent diminished ovarian reserve or ovarian failure. The mechanism by which this treatment might prevent premature menopause is unclear – some theories include the decrease in ovarian perfusion, the suppression of pituitary FSH, and the activation of GnRH receptors. |
Prior Studies about GnRHa and ovarian reserve: |
A systemic review and meta-analysis of 13 studies (3 randomized controlled trials and 10 non-randomized studies) showed that GnRH agonist treatment resulted in a higher likelihood of preserved ovarian function. However, when they limited the analysis to only randomized-controlled trials, there was no statistically significant difference6. |
References
1. Del Mastro L, Boni L, Michelotti A, et al. Effect of the gonadotropin-releasing hormone analogue triptorelin on the occurrence of chemotherapy-induced early menopause in premenopausal women with breast cancer: a randomized trial. JAMA. Jul 20 2011;306(3):269-276.
2. Badawy A, Elnashar A, El-Ashry M, Shahat M. Gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage: prospective randomized study. Fertil Steril. Mar 2009;91(3):694-697.
3. Gerber B, von Minckwitz G, Stehle H, et al. Effect of luteinizing hormone-releasing hormone agonist on ovarian function after modern adjuvant breast cancer chemotherapy: the GBG 37 ZORO study. J Clin Oncol. Jun 10 2011;29(17):2334-2341.
4. Leonard RC AD, Anderson R. The OPTION trial of adjuvant ovarian protection by goserelin in adjuvant chemotherapy for early breast cancer. J Clin Oncol. 2010;28((supp)):15S.
5. Ismail-Khan R MS, Cox C. Preservation of ovarian function in young women treated with neoadjuvant chemotherapy for breast cancer: a randomized trial using the GnRH agonist triptoreline during chemotherapy [abstract]. J Clin Oncol. 2008((supp)):26.
6. Kim SS, Lee JR, Jee BC, et al. Use of hormonal protection for chemotherapy-induced gonadotoxicity. Clin Obstet Gynecol. Dec 2010;53(4):740-752.
About the Author
Jennifer Mersereau, MD, MSCI, is an reproductive endocrinologist in the University of North Carolina's Department of Obstetrics and Gynecology. As the Director of the Fertility Preservation Program, she has extensive experience guiding patients and physicians through the oncofertility experience.
This page was last updated March 14, 2012.