Abstract
Purpose
To examine ovarian reserve following chemotherapy in women with Hodgkin’s disease.
Methods
The study included nine patients who underwent ovarian tissue cryopreservation (OTCP) prior to chemotherapy consisting of the ABVD regimen (Adriamycin, bleomycin, vinblastine, and dacarbazine) and co-treatment with gonadotropin-releasing hormone agonist (GnRH-a) (Group A), and 13 patients treated by the ABVD protocol only without GnRH-a (Group B). The average age was 25.2 ± 2.7 years for the women in Group A and 31.8 ± 6.8 years for those in Group B.
Results
Six months following the end of chemotherapy, the menstrual cycle resumed in all Group A patients and in four Group B patients who had amenorrhea. Eight Group B patients had regular menses during and after chemotherapy. None of the patients suffered from ovarian failure. Two Group A patients conceived in the first year after completing chemotherapy.
Conclusions
Co-treatment with GnRH-a has little effect on ovarian protection in women with Hodgkin’s disease.
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References
Kogel KE, Sweetenham JW. Current therapies in Hodgkin’s disease. Eur J Nucl Med Mol Imaging. 2003;30(Suppl 1):S19–27.
Canellos GP, Anderson JR, Propert KJ, Nissen N, Cooper MR, Henderson ES, et al. Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD or MOPP alternating with ABVD. N Engl J Med. 1992;327:1478.
Blumenfeld Z, Haim N. Prevention of gonadal damage during cytotoxic therapy. Ann Med. 1997;29:199–206. doi:10.3109/07853899708999337.
Waxman JH, Ahmed R, Smith D, Wrigley PF, Gregory W, Shalet S. Failure to preserve fertility in patients with Hodgkin’s disease. Cancer Chemother Pharmacol. 1987;19:159–62. doi:10.1007/BF00254570.
Oktay K, Sonmerz M. Ovarian tissue banking, not just ovarian cryopreservation. Hum Reprod. 2004;19:477–80. doi:10.1093/humrep/deh152.
Gosden RG, Wade JC, Fraser HM, Sandow J, Faddy MJ. Impact of congenital or experimental hypogonadotropism on radiation sensitivity of the mouse ovary. Hum Reprod. 1997;12:2483–8. doi:10.1093/humrep/12.11.2483.
Azem F, Yovel I, Wagman I, Kapostiansky R, Lessing JB, Amit A. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries. Fertil Steril. 2003;79:1229–30. doi:10.1016/S0015-0282(03)00148-1.
Porcu E, Venturoli S. Progress with oocyte cryopreservation. Curr Opin Obstet Gynecol. 2006;18:273–9. doi:10.1097/01.gco.0000193015.96275.2d.
Meirow D, Levron J, Eldar-Geva T, Hardan I, Frideman E, Zalel Y, Schiff E, Dor J. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005;353:318–21. doi:10.1056/NEJMc055237.
Bukman A, Heineman MJ. Ovarian reserve testing and the use of prognostic models in patients with subfertility. Hum Reprod Update. 2001;7:581–90. doi:10.1093/humupd/7.6.581.
Bukulmetz O, Arici A. Assessment of ovarian reserve. Curr Opin Obstet Gynecol. 2004;16:231–7. doi:10.1097/00001703-200406000-00005.
van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, de Jong FH, Themmen AP. Serum anti mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod. 2002;17:3065–71. doi:10.1093/humrep/17.12.3065.
Ficicioglu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimullerian hormone as an indicator of ovarian reserve. Fertil Steril. 2006;85:592–6. doi:10.1016/j.fertnstert.2005.09.019.
La Marca A, Volpe A. Anti mullerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool? Clin Endicrinoligy. 2006;64:603–10. doi:10.1111/j.1365-2265.2006.02533.x.
Ebner T, Sommergruber M, Moser M, Shebl O, Schreier-Lechner E, Tews G. Basal level of anti mullerian hormone is associated with oocyte quality in stimulated cycles. Hum Reprod. 2006;21:2022–6. doi:10.1093/humrep/del127.
Gosden RG, Baird DT, Wade JC, Webb R. Restoration of fertility to oophoroctomized sheep by ovarian autografts stored at −196°C. Hum Reprod. 1994;9:597–603.
Pacheco BP, Mendez Ribas JM, Milone G, Fernandez I, Kvicala R, Mila T, Di Noto A, Ortiz OC, Pavlovsky S. Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report. Gynecol Oncol. 2001;81:391–7. doi:10.1006/gyno.2001.6181.
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Capsule Ovarian tissue banking with combined GnRH-a and ABVD given to patients with Hodgkin’s disease minimally affects ovarian function, similar to ABVD administered alone.
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Azem, F., Samara, N., Cohen, T. et al. Assessment of ovarian reserve following ovarian tissue banking and/or GnRH-a co-treatment prior to chemotherapy in patients with Hodgkin’s disease. J Assist Reprod Genet 25, 535–538 (2008). https://doi.org/10.1007/s10815-008-9276-4
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DOI: https://doi.org/10.1007/s10815-008-9276-4