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- Title
Leuprolide Protects Ovarian Reserve in Adolescents Undergoing Gonadotoxic Therapy.
- Authors
Hoyos-Martinez, Alfonso; Scheurer, Michael E.; Allen-Rhoades, Wendy; Okcu, M. Fatih; Horne, Vincent E.
- Abstract
Purpose: Treatment sequelae compromising reproductive health are highly prevalent in childhood cancer survivors, and a main determinant of health and quality of life. Follicular reserve determines ovarian function life span; thus, its preservation is important in the care of female survivors. Anti-Müllerian hormone (AMH) is a biomarker to measure functional ovarian reserve. We aimed to evaluate the effect of leuprolide during gonadotoxic therapy on pubertal females' post-treatment functional ovarian reserve using AMH levels. Methods: We conducted a single-center retrospective study including all pubertal females who had undergone gonadotoxic treatments between January 2010 and April 2020, and had an AMH level after completion of therapy. We used multivariable linear regressions to compare AMH-level beta coefficients in patients stratified by gonadotoxic risk, adjusting for leuprolide use. Results: Fifty-two females meeting study eligibility were included, of which 35 received leuprolide. The use of leuprolide was associated with higher post-treatment AMH levels in the lower gonadotoxic risk group (beta 2.74, 95% CI 0.97–4.51; p = 0.004). This association was lost in the higher gonadotoxic risk groups. Conclusions: Leuprolide may have a protective effect on the functional ovarian reserve. However, this is limited by increasing treatment gonadotoxicity. Larger, prospective studies are needed to elucidate the potential benefits of gonadotropin-releasing hormone agonist on preservation of ovarian reserve among children receiving gonadotoxic therapies, as cancer survivors.
- Subjects
THERAPEUTIC use of sex hormones; OVARIES; CANCER patient psychology; BIOMARKERS; LEUPROLIDE; CONFIDENCE intervals; MULTIPLE regression analysis; ANTINEOPLASTIC agents; RETROSPECTIVE studies; OVARIAN reserve; DRUG administration; CANCER patients; RISK assessment; COMPARATIVE studies; FERTILITY preservation; QUALITY of life; DESCRIPTIVE statistics; LONGEVITY; LONGITUDINAL method; REPRODUCTIVE health; CHILDREN; ADOLESCENCE
- Publication
Journal of Adolescent & Young Adult Oncology, 2023, Vol 12, Issue 6, p828
- ISSN
2156-5333
- Publication type
Article
- DOI
10.1089/jayao.2022.0128