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A New Therapy to Protect Cancer Patients Against Infertility

The 23rd annual conference of the European Society of Human Reproduction and Embryology today revealed a promising new therapy for protecting the fertility of women with cancer and auto-immune diseases such as lupus.

Dr. Kate Stern, Research Director of the Royal Womens Hospital, Melbourne, Australia, told the conference that her pilot study had shown gonadotropin-releasing hormone (GnRH) antagonists were likely to be able to protect the ovary in women receiving potentially toxic doses of chemotherapy. We are now hoping to carry out a randomised controlled trial to assess the long term protective effect of this treatment, she said.

GnRH analogues are commonly used in the management of womens disorders that are dependent on oestrogen production, and in IVF therapies. Dr. Stern and her team studied women between the ages of 18 and 35 years who were due to receive high doses of cyclophosphamide, a chemotherapy drug.

They knew that GnHR analogues were already used for the temporary suppression of ovulation in infertility treatment, so reasoned that it would be possible to use it to shut down the ovaries temporarily during the time that chemotherapy was administered, and hence protect them from the effect of the drugs.

The women were given the GnRH antagonist cetrorelix by 3 subcutaneous injections, each of them four days apart, concurrently with their chemotherapy.

The scientists observed that there was evidence that ovarian function was suppressed, but that this returned to normal after chemotherapy stopped. Follicle stimulating hormone levels were up in 73% of the patients, but these also subsequently returned to normal. 94% of the patients resumed spontaneous ovulation and menses within 12 months.

We believe that using GnRH antagonists in this way could reduce the side effects of chemotherapy over a long period, said Dr. Stern. Other studies have tried to analyse whether similar tr
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