Hebatallah Ahmed Mohamed Moustafa, Al Shaimaa Ibrahim Rabie, Ahmed Abdullah Elberry, Ahmed Hassan Shaaban, Amany Mohamed Alboghdadly, Hind Khalid Goresh, Muath Fahmi Najjar, Mabrouk Al-Rasheedi, Raghda R S Hussein
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Its treatment has a cytotoxic effect on all body tissues, especially female ovaries, yielding premature ovarian insufficiency.</p><p><strong>Objectives: </strong>This study aimed to compare the fertility and ovarian preserving role of gonadotropin-releasing hormone agonists (GnRH-a) when administered in conjunction with chemotherapy in women treated for lymphomas.</p><p><strong>Design: </strong>Only prospective clinical trials were included in this systematic review.</p><p><strong>Data sources and methods: </strong>We searched for pertinent studies in PubMed, Web of Science, Cochrane Library, Google Scholar, and Scopus till April 2025. Available prospective clinical trials comparing patients with Hodgkin lymphoma and non-Hodgkin lymphoma receiving concurrent chemotherapy and GnRH-a with patients receiving chemotherapy alone were included. The main outcomes were cyclic ovarian function (COF), pregnancy rate, follicle-stimulating hormone (FSH) level, luteinizing hormone level, estradiol level, and anti-Mullerian hormone (AMH) level. Cochrane's risk of bias tool for clinical trials was used for the risk of bias assessment, and all the included studies were deemed of acceptable quality.</p><p><strong>Results: </strong>Twelve prospective clinical trials involving 733 women were analyzed, with 374 patients receiving GnRH-a and 359 as controls. The mean age of the GnRH-a group was 25.86 years, compared to 27.62 years in the control group. GnRH-a administration was associated with a notably higher COF, higher pregnancy rates, lower FSH levels, and higher AMH levels compared to controls. No significant difference between the groups was observed in estradiol levels.</p><p><strong>Conclusion: </strong>Co-administration of GnRH-a during chemotherapy in women with lymphoma appears to offer a protective effect against ovarian damage and supports fertility preservation in women with lymphoma. These findings advocate for the integration of GnRH-a into fertility preservation strategies, emphasizing its potential to improve long-term reproductive health in this vulnerable patient population. However, further high-quality, large-scale studies are warranted to standardize protocols and confirm these findings for broader clinical applications.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"16 ","pages":"20406223251356815"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290369/pdf/","citationCount":"0","resultStr":"{\"title\":\"Preservation of ovarian endocrine function in patients with lymphoma: a systematic review.\",\"authors\":\"Hebatallah Ahmed Mohamed Moustafa, Al Shaimaa Ibrahim Rabie, Ahmed Abdullah Elberry, Ahmed Hassan Shaaban, Amany Mohamed Alboghdadly, Hind Khalid Goresh, Muath Fahmi Najjar, Mabrouk Al-Rasheedi, Raghda R S Hussein\",\"doi\":\"10.1177/20406223251356815\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lymphomas represent various groups of cancers. 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The main outcomes were cyclic ovarian function (COF), pregnancy rate, follicle-stimulating hormone (FSH) level, luteinizing hormone level, estradiol level, and anti-Mullerian hormone (AMH) level. Cochrane's risk of bias tool for clinical trials was used for the risk of bias assessment, and all the included studies were deemed of acceptable quality.</p><p><strong>Results: </strong>Twelve prospective clinical trials involving 733 women were analyzed, with 374 patients receiving GnRH-a and 359 as controls. The mean age of the GnRH-a group was 25.86 years, compared to 27.62 years in the control group. GnRH-a administration was associated with a notably higher COF, higher pregnancy rates, lower FSH levels, and higher AMH levels compared to controls. 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引用次数: 0
摘要
背景:淋巴瘤代表不同类型的癌症。其治疗对所有身体组织,特别是女性卵巢有细胞毒性作用,导致卵巢功能不全。目的:本研究旨在比较促性腺激素释放激素激动剂(GnRH-a)联合化疗对女性淋巴瘤患者的生育和卵巢保护作用。设计:本系统综述仅纳入前瞻性临床试验。数据来源和方法:我们检索了PubMed、Web of Science、Cochrane Library、b谷歌Scholar和Scopus的相关研究,检索时间截止到2025年4月。纳入了比较同时接受化疗和GnRH-a的霍奇金淋巴瘤和非霍奇金淋巴瘤患者与单独接受化疗的患者的现有前瞻性临床试验。主要观察指标为卵巢循环功能(COF)、妊娠率、促卵泡激素(FSH)水平、促黄体生成素水平、雌二醇水平、抗苗勒管激素(AMH)水平。采用Cochrane临床试验偏倚风险评估工具进行偏倚风险评估,所有纳入的研究质量均可接受。结果:共分析了12项前瞻性临床试验,涉及733名女性,其中374名患者接受GnRH-a治疗,359名作为对照。GnRH-a组的平均年龄为25.86岁,对照组的平均年龄为27.62岁。与对照组相比,给予GnRH-a与显著较高的COF、较高的妊娠率、较低的FSH水平和较高的AMH水平相关。各组间雌二醇水平无显著差异。结论:在淋巴瘤妇女化疗期间联合给予GnRH-a似乎对卵巢损伤具有保护作用,并支持淋巴瘤妇女的生育能力保存。这些发现提倡将GnRH-a整合到生育保护策略中,强调其改善弱势患者群体长期生殖健康的潜力。然而,需要进一步的高质量、大规模的研究来标准化方案,并为更广泛的临床应用证实这些发现。
Preservation of ovarian endocrine function in patients with lymphoma: a systematic review.
Background: Lymphomas represent various groups of cancers. Its treatment has a cytotoxic effect on all body tissues, especially female ovaries, yielding premature ovarian insufficiency.
Objectives: This study aimed to compare the fertility and ovarian preserving role of gonadotropin-releasing hormone agonists (GnRH-a) when administered in conjunction with chemotherapy in women treated for lymphomas.
Design: Only prospective clinical trials were included in this systematic review.
Data sources and methods: We searched for pertinent studies in PubMed, Web of Science, Cochrane Library, Google Scholar, and Scopus till April 2025. Available prospective clinical trials comparing patients with Hodgkin lymphoma and non-Hodgkin lymphoma receiving concurrent chemotherapy and GnRH-a with patients receiving chemotherapy alone were included. The main outcomes were cyclic ovarian function (COF), pregnancy rate, follicle-stimulating hormone (FSH) level, luteinizing hormone level, estradiol level, and anti-Mullerian hormone (AMH) level. Cochrane's risk of bias tool for clinical trials was used for the risk of bias assessment, and all the included studies were deemed of acceptable quality.
Results: Twelve prospective clinical trials involving 733 women were analyzed, with 374 patients receiving GnRH-a and 359 as controls. The mean age of the GnRH-a group was 25.86 years, compared to 27.62 years in the control group. GnRH-a administration was associated with a notably higher COF, higher pregnancy rates, lower FSH levels, and higher AMH levels compared to controls. No significant difference between the groups was observed in estradiol levels.
Conclusion: Co-administration of GnRH-a during chemotherapy in women with lymphoma appears to offer a protective effect against ovarian damage and supports fertility preservation in women with lymphoma. These findings advocate for the integration of GnRH-a into fertility preservation strategies, emphasizing its potential to improve long-term reproductive health in this vulnerable patient population. However, further high-quality, large-scale studies are warranted to standardize protocols and confirm these findings for broader clinical applications.
期刊介绍:
Therapeutic Advances in Chronic Disease publishes the highest quality peer-reviewed research, reviews and scholarly comment in the drug treatment of all chronic diseases. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers involved in the medical treatment of chronic disease, providing a forum in print and online for publishing the highest quality articles in this area.