Preservation of gonadal function in women undergoing chemotherapy: A review of the potential role for gonadotropin-releasing hormone agonists

abstract:
Preservation of gonadal function in women undergoing chemotherapy: A review of the potential role for gonadotropin-releasing hormone agonists - American Journal of Obstetrics & Gynecology

 A cancer diagnosis in women of reproductive age has unique medical and psychosocial ramifications, especially with treatments known to cause gonadal toxicity. For patients undergoing chemotherapy, a multidisciplinary team approach is essential to ensure that the patients’ reproductive wishes are addressed. Currently embryo and oocyte cryopreservation are the standard of care for those who wish to preserve their fertility. The use of gonadotropin releasing hormone agonists (GnRHa) has been a source of debate with numerous studies investigating the efficacy on both fertility and ovarian function preservation. This review will evaluate the current literature on the use of GnRHa for preservation of gonadal function. Assisted reproductive technology is excellent for preservation of fertility but will not protect gonadal function. Protection of gonadal function is critical for the broader issues of health and quality of life as a result of a hypogonadal state. At this moment, GnRHa are the only drug class available to protect gonadal function.