| Gonadotropin-releasing hormone analog cotreatment for preservation of ovarian function during gonadotoxic chemotherapy: a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 21145541 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mohamed A Bedaiwy; Ahmed M Abou-Setta; Nina Desai; William Hurd; David Starks; Sherif A El-Nashar; Hesham G Al-Inany; Tommaso Falcone |
Publication Detail:
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Type: Journal Article; Meta-Analysis; Review Date: 2010-12-10 |
Journal Detail:
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Title: Fertility and sterility Volume: 95 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-22 Completed Date: 2011-04-22 Revised Date: 2011-11-04 |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 906-14.e1-4 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antineoplastic Agents
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adverse effects* Female Gonadotropin-Releasing Hormone / administration & dosage* Humans Incidence Infertility, Female / chemically induced, epidemiology, prevention & control Neoplasms / drug therapy*, epidemiology Pregnancy Pregnancy Rate Primary Ovarian Insufficiency / chemically induced*, epidemiology, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 33515-09-2/Gonadotropin-Releasing Hormone |
| Comments/Corrections | |
Comment In:
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Fertil Steril. 2011 Oct;96(4):e155-6; author reply e157
[PMID:
21862002
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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