Ovarian Function Preservation in Premenopausal Cancer Patients on Chemotherapy

Background: Cancer therapies can negatively affect ovarian function, making fertility preservation a key concern for young patients. Gonadotropin-releasing hormone agonists (GnRHa) provide a non-surgical option for women who are unable to pursue or decline other fertility preservation techniques.
Objectives: This study aimed to evaluate the impact of using GnRHa alongside chemotherapy in breast cancer patients of childbearing age.
Patients and methods: This retrospective cohort study was conducted at the Oncology Center Mansoura University (OCMU). It included 30 patients with breast cancer. All participants underwent detailed medical history, physical examinations, and a range of laboratory and radiological investigations. Pathological assessments included evaluating ER, PR, Her-2neu status, Ki67, and FSH/E2 levels.
Results: Of the patients studied, 96% (26 of 27) regained regular menstruation, with 16 cases resuming menses within six months of chemotherapy. Three patients had unknown data due to hormonal pill use. One 45-year-old patient experienced amenorrhea with postmenopausal FSH and E2 levels. Two out of nine patients (22.2%) who tried to conceive achieved a full-term pregnancy. The 24 patients (80%) who did not conceive cited various reasons including being unmarried (16.6%), having completed their family (54.1%), local recurrence (12.5%), distant metastasis (4.1%), and actively seeking fertility (12.5%).
Conclusion: Using GnRHa with chemotherapy appears beneficial for fertility preservation, although efficacy varies with cancer type, treatment, and individual patient factors. This highlighted GnRHa's role in mitigating chemotherapy-induced ovarian toxicity, particularly in patients on high-infertility-risk regimens.