Potential Mechanisms of Ovarian Protection with Gonadotropin-Releasing Hormone Agonist in Breast Cancer Patients: A Review

Clinical Medicine Insights-Reproductive Health Pub Date : 2019-07-01 DOI:10.1177/1179558119864584

F. Poggio, M. Lambertini, C. Bighin, B. Conte, E. Blondeaux, A. D’Alonzo, C. Dellepiane, G. Buzzatti, C. Molinelli, F. Boccardo, L. Del Mastro

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引用次数: 21

Abstract

The use of chemotherapy in premenopausal cancer patients may lead to chemotherapy-induced premature ovarian failure. Pharmacological temporary ovarian suppression obtained with the gonadotropin-releasing hormone agonist (GnRHa) administered concomitantly with chemotherapy has been investigated as a technique capable to reduce the gonadotoxicity, reducing the risk of developing premature menopause. In recent years, important evidence has become available on the efficacy and safety of this strategy that should now be considered a standard option for ovarian function preservation in premenopausal breast cancer patients. However, in women interested in fertility preservation, this is not an alternative to cryopreservation strategies, which remains the first option to be proposed. The purpose of this review is to summarize the mechanisms of GnRHa in the preservation of fertility in premenopausal cancer patient candidates to receive chemotherapy, highlighting the areas of doubt that require further investigation.

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促性腺激素释放激素激动剂对乳腺癌患者卵巢保护的潜在机制综述

绝经前癌症患者使用化疗可能导致化疗诱导的卵巢早衰。与化疗同时使用促性腺激素释放激素激动剂(GnRHa)获得的药理学暂时卵巢抑制已被研究为一种能够降低促性腺毒性的技术，降低过早绝经的风险。近年来，关于这种策略的有效性和安全性的重要证据已经出现，现在应该被认为是绝经前乳腺癌患者卵巢功能保护的标准选择。然而，对于对保留生育能力感兴趣的女性来说，这并不是冷冻保存策略的替代选择，冷冻保存策略仍然是第一选择。本综述的目的是总结GnRHa在保留绝经前癌症患者接受化疗的生育能力方面的机制，强调需要进一步研究的疑问领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Medicine Insights-Reproductive Health OBSTETRICS & GYNECOLOGY-

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Medicine Insights: Reproductive Health is a peer reviewed; open access journal, which covers all aspects of Reproduction: Gynecology, Obstetrics, and Infertility, spanning both male and female issues, from the physical to the psychological and the social, including: sex, contraception, pregnancy, childbirth, and related topics such as social and emotional impacts. It welcomes original research and review articles from across the health sciences. Clinical subjects include fertility and sterility, infertility and assisted reproduction, IVF, fertility preservation despite gonadotoxic chemo- and/or radiotherapy, pregnancy problems, PPD, infections and disease, surgery, diagnosis, menopause, HRT, pelvic floor problems, reproductive cancers and environmental impacts on reproduction, although this list is by no means exhaustive Subjects covered include, but are not limited to: • fertility and sterility, • infertility and ART, • ART/IVF, • fertility preservation despite gonadotoxic chemo- and/or radiotherapy, • pregnancy problems, • Postpartum depression • Infections and disease, • Gyn/Ob surgery, • diagnosis, • Contraception • Premenstrual tension • Gynecologic Oncology • reproductive cancers • environmental impacts on reproduction, • Obstetrics/Gynaecology • Women''s Health • menopause, • HRT, • pelvic floor problems, • Paediatric and adolescent gynaecology • PID