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Hum. Reprod. Advance Access originally published online on February 7, 2008
Human Reproduction 2008 23(4):863-868; doi:10.1093/humrep/den005
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prevention of ovarian function damage by a GnRH analogue during chemotherapy in Hodgkin lymphoma patients

M. Huser1,4, I. Crha1, P. Ventruba1, R. Hudecek1, J. Zakova1, L. Smardova2, Z. Kral2 and J. Jarkovsky3

1 Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University School of Medicine, Brno, Czech Republic 2 Department of Internal Medicine and Hematooncology, Brno University Hospital and Masaryk University School of Medicine, Brno, Czech Republic 3 Institute of Biostatistics and Analyses of the Masaryk University, Brno University Hospital and Masaryk University School of Medicine, Brno, Czech Republic

4 Correspondence address. E-mail: martin.huser{at}gmail.com

BACKGROUND: Frequent negative consequence of chemotherapy (CHT) is ovarian damage and premature ovarian failure (POF). Aim of this prospective case–control study is evaluation of GnRH analogue (GnRH-a) administration to patients with Hodgkin lymphoma (HL) during CHT and prevention of ovarian damage depending upon CHT regimen.

METHODS: Study group consists of 72 patients in fertile age (18–35 years) with HL diagnosis treated in 2004–2005 by curative CHT together with GnRH analogue (Triptorelin) administration according to a standardized protocol. Patients were divided into three groups according to the stage of disease and treated by three types of CHT regimens (A,B,C) with increased cytotoxicity. Ovarian function of all patients was assessed by gonadotrophin levels (FSH, LH) analysis from peripheral blood before treatment and also 6 and 12 month after it. The number of women with POF after CHT in study group was compared with control group (n = 45, age 18–35 years) of patients treated in 2002–2003 according to the same protocol but without protective GnRH analogue application.

RESULTS: In study group with GnRH analogue administration during CHT, there was significantly (P < 0.001) fewer cases with POF 6 and 12 month after the end of CHT (37.5% and 20.8%, respectively) than in control group (73.3% and 71.1%, respectively). Comparative analysis depending on cytotoxicity of CHT regimen used showed significant differences in percentage of patient with acquired POF between study and control group only in less aggressive CHT protocols.

CONCLUSIONS: Study showed a significant reduction of ovarian failure risk in women with HL treated with less aggressive CHT regimens plus a GnRH analogue.

Key words: GnRH-agonists/infertility/ovarian failure/Hodgkin lymphoma/chemotherapy

Submitted on August 5, 2007; resubmitted on December 23, 2007; accepted on January 8, 2008.


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