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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Gonadotropin-releasing hormone analog cotreatment for preservation of ovarian function during gonadotoxic chemotherapy: A systematic review and meta-analysis
Fertility and Sterility, Volume 95, No. 3, Year 2011
Notification
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Description
Objective: To determine whether gonadotropin-releasing hormone (GnRH) analog cotreatment with chemotherapy provides better reproductive outcomes for women at risk of premature ovarian failure (POF) as a side-effect of gonadotoxic chemotherapy. Design: Systematic review and meta-analysis. Setting: University-affiliated research centers. Patient(s): None. Intervention(s): Electronic and manual searches (e.g., MEDLINE, EMBASE, CENTRAL) up to January 2010 were performed to identify randomized controlled trials (RCTs) comparing GnRH cotreatment with chemotherapy alone in premenopausal women. Main Outcome Measure(s): Incidence of POF after treatment, incidence of women with resumption of ovulation, POF after an initial normal cycle, normal cycles but abnormal markers of ovarian reserve, spontaneous occurrence of pregnancy after treatment, and time to reestablishment of menstruation; data also extracted to allow for an intention-to-treat analysis. Result(s): Twenty-eight RCTs were identified, but only six met the inclusion criteria. Data were only available for the incidence of women with new onset of POF, resumption of ovulation, and occurrence of pregnancy. The incidence of POF or resumption of ovulation both demonstrated a statistically significant difference in favor of the GnRH cotreatment. The occurrence of spontaneous pregnancy showed no statistically significant difference between GnRH cotreatment and the control groups. Conclusion(s): Evidence from RCTs suggests a potential benefit of GnRH cotreatment with chemotherapy in premenopausal women, with higher rates of spontaneous resumption of menses and ovulation but not improvement in pregnancy rates. Data relating to study quality and possible bias for the majority of the outcomes in this review were not available, denoting possible selective reporting of trial data. ©2011 by American Society for Reproductive Medicine.
Authors & Co-Authors
Bedaiwy, Mohamed Ali
United States, Cleveland
University Hospitals Case Medical Center
Egypt, Asyut
Assiut University
Abou-Setta, Ahmed M.
Canada, Edmonton
Alberta Research Centre for Health Evidence
Desai, Nina
United States, Cleveland
Cleveland Clinic Foundation
Hurd, William W.
United States, Cleveland
University Hospitals Case Medical Center
Starks, David
United States, Cleveland
University Hospitals Case Medical Center
El-Nashar, Sherif A.
Egypt, Asyut
Assiut University
Al-Inany, Hesham Gaber
Egypt, Cairo
Faculty of Medicine
Falcone, Tommaso
United States, Cleveland
Cleveland Clinic Foundation
Statistics
Citations: 152
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1016/j.fertnstert.2010.11.017
ISSN:
00150282
Research Areas
Cancer
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Systematic review
Participants Gender
Female