IMR Press / EJGO / Volume 25 / Issue 1 / pii/2004116

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research

Protocol combining GnRH agonists and GnRH antagonists for rapid suppression and prevention of gonadal damage during cytotoxic therapy

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1 Sanatorium Pronatal, 2nd Department of Paediatrics, University Hospital Motol, Prague (Czech Republic)
2 Endocrine, 2nd Department of Paediatrics, University Hospital Motol, Prague (Czech Republic)
3 Haematological Unit, 2nd Department of Paediatrics, University Hospital Motol, Prague (Czech Republic)
Eur. J. Gynaecol. Oncol. 2004, 25(1), 90–92;
Published: 10 February 2004
Abstract

Purpose of investigation: Infertility represents one of the main sequelae of cytotoxic therapy given for various malignant diseases. Because dividing cells are more sensitive to cytotoxic effects than are cells at rest, it has been hypothesized that inhibition of the pituitary-gonadal axis may facilitate the preservation of future gonadal function. The aim of our study was to find a quick, reliable and economic way to suppress the pituitary-gonadal axis by combining GnRH-agonists with GnRH-antagonists in order to preserve future gonadal function. Methods: A combination of D-Trp6-GnRH-a (3.75 mg) and cetrorelix (3 mg) was used to achieve a quick downregulation in six postmenarchal young women (aged 15.4 ± 0.7) years with haematological malignancies before the onset of cytotoxic chemotherapy. Results: The combination of D-Trp6-GnRH-a and GnRH-antagonist cetrorelix induced a reliable and long-lasting suppression of gonadotrophin secretion within 96 hours in all patients allowing cytotoxic therapy to be started without any delay. Conclusions: The combination of GnRH-agonist and GnRH-antagonist enables a rapid, reliable and cost-effective suppression of the pituitary-gonadal axis to be achieved. Future gonadal function of treated patients will be monitored.

Keywords
Chemotherapy
GnRH-analogues
Gonadotoxicity
Fertility
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