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Endocrine prevention of chemotherapy-induced ovarian failure

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CURRENT OPINION IN OBSTETRICS & GYNECOLOGY
卷 28, 期 4, 页码 223-229

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GCO.0000000000000278

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fertility preservation; gonadotropin-releasing hormone agonist; gonadotoxicity; pregnancies after chemotherapy; premature ovarian failure

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Purpose of review Fertility preservation has recently gained a worldwide interest among fertility specialists, oncologists, and all healthcare providers. Thus, the protection against iatrogenic infertility caused by chemotherapy assumes a high priority. Specifically, the issue of endocrine prevention of gonadotoxicity is still a controversial subject. Recent findings During the last year, many publications on this subject appeared, swinging the pendulum toward the beneficial role of gonadotropin-releasing hormone agonist (GnRHa) cotreatment for fertility preservation despite gonadotoxic chemotherapy. Here, we summarize the recent publications on fertility preservation and minimizing chemotherapy-induced gonadotoxicity. Summary More than 10 recent meta-analyses have concluded that GnRHa is beneficial and may decrease the risk of premature ovarian failure and increase the pregnancy rate in survivors. Furthermore, two recent international meetings of experts have concluded that GnRHa is effective and should be offered to every young woman facing gonadotoxic chemotherapy.

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