Gonadotropin-releasing hormone analog cotreatment for preservation of ovarian function during gonadotoxic chemotherapy: a systematic review and meta-analysis.

摘要: 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 gonadotoxic chemotherapy. Design Systematic review and meta-analysis. Setting University-affiliated research centers. Patient(s) None. Intervention(s) Electronic manual searches (e.g., MEDLINE, EMBASE, CENTRAL) up to January 2010 were performed identify randomized controlled trials (RCTs) comparing GnRH alone in premenopausal women. Main Outcome Measure(s) Incidence POF after treatment, incidence resumption ovulation, an initial normal cycle, cycles but abnormal markers reserve, spontaneous occurrence pregnancy time reestablishment menstruation; data also extracted allow intention-to-treat analysis. Result(s) Twenty-eight RCTs identified, only six met the inclusion criteria. Data available new onset POF, pregnancy. The or ovulation both demonstrated statistically significant difference favor cotreatment. showed no between control groups. Conclusion(s) Evidence from suggests potential benefit women, higher rates menses not improvement rates. relating study quality possible bias majority this available, denoting selective reporting trial data.