JOURNAL OF WOMENS HEALTH Volume 18, Number 9, 2009 Mary Ann Liebert, Inc. DOI: 10.1089=jwh.2009.

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Letter to the Editor

Ovarian Function Preservation by GnRH Agonists during Chemotherapy

Zeev Blumenfeld, M.D.

have read with great interest the recent meta-analysis by Clowse et al.1; the authors are congratulated for their ne review. There is, however, a small mistake in reporting the results of Waxman et al.2 This study, from 1987, found that 4 of the 8 patients in the GnRH agonists (GnRHa) group suffered Premature Ovarian Failure (POF) (50.0%) vs. 6 of the 9 patients in the control group (66.7%), not as erroneously reported by Clowse et al.1: 6=9 of the controls preserved ovarian function. This may change the nal results in the same direction as the authors found, and may even strengthen their conclusion. Also, in the last few months, two prospective randomized controlled (RCT) studies have found a statistically signicant advantage of GnRHa cotreatment in preserving ovarian function.3,4 The rst of these two peerreviewed RCTs,3 found 11.4% POF in the GnRHa group vs. 66% POF in controls ( p < 0.001). Similarly, the second RCT concluded that: Among women treated with goserelin, there was a statistically signicant increase in the proportion of menstruating women, and protective effect of goserelin on ovarian function in CMF treated women.4 References
1. Clowse MEB, Behera MA, Anders CK, et al. Ovarian preservation by GnRH agonists during chemotherapy: A metaanalysis. J Womens Health 2009;18:311319.

2. Waxman JH, Ahmed R, Smith D, et al. Failure to preserve fertility in patients with Hodgkins disease. Cancer Chemother Pharmacol 1987;19:159162. 3. Badawy A, Elnashar A, El-Ashry, et al. Gonadotropinreleasing hormone agonists for prevention of chemotherapyinduced ovarian damage: Prospective randomized study. Fertil Steril 2009;91:694697. 4. Sverrisdottir A, Nystedt M, Johansson H, Fornander T. Adjuvant goserelin and ovarian preservation in chemotherapy treated patients with early breast cancer: Results from a randomized trial. Breast Cancer Res Treat. Published online January 20, 2009 (epub ahead of print).

Address correspondence to: Zeev Blumenfeld, M.D. Reproductive Endocrinology Department of Obstetrics and Gynecology Rambam Health Care Campus Rappaport Institute Technion-Faculty of Medicine Bath-Galim Haifa Israel, 31096 E-mail: z_blumenfeld@rambam.health.gov.il

Reproductive Endocrinology, Department of Obstetrics and Gynecology, Rappaport Institute and Faculty of Medicine, Bath-Galim, Haifa, Israel.

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