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Archives of Gynecology and Obstetrics

, Volume 282, Issue 6, pp 717–718 | Cite as

Comments on the letter “Fertility preservation and GnRHa for chemotherapy: debate”

  • Michael von WolffEmail author
  • Juliane Raddatz
  • Michael K. Bohlmann
  • Petra Stute
  • Thomas Strowitzki
  • Markus Nitzschke
Letter to the Editor

Thank you very much for the critical comments. Any critical comment on the use of GnRH analogs (GnRHa) to protect fertility during chemotherapy is of great value in further discussions of the controversial data and the controversial attitudes of endocrinologists and ocologists.

We fully agree with the authors of the letter that several studies support the efficacy of GnRHa to protect the ovaries, which we have also demonstrated in a review summarizing nine studies on the use of GnRHa [1]. We also agree with the authors that the efficacy of other fertility preserving techniques such as cryopreservation and transplantation of ovarian tissue need further evaluation and that their safety has still not absolutely been proven, as stated in our recent review about cryopreservation of ovarian tissue [2]. Finally, we are fully aware that GnRHa provide several additional advantages during chemotherapy such as reducing the risk of thrombocytopenia-associated menorrhagia.

However, we do not agree...

Keywords

Breast Cancer Patient Ovarian Tissue Ovarian Stimulation Fertility Preservation GnRH Analog 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest statement

None.

References

  1. 1.
    Blumenfeld Z, von Wolff M (2008) GnRH-analogues and oral contraceptives for fertility preservation in women during chemotherapy. Hum Reprod Update 14:543–552CrossRefPubMedGoogle Scholar
  2. 2.
    von Wolff M, Donnez J, Hovatta O, Keros V, Maltaris T, Montag M, Salle B, Sonmezer M, Andersen CY (2009) Cryopreservation and autotransplantation of human ovarian tissue prior to cytotoxic therapy—a technique in its infancy but already successful in fertility preservation. Eur J Cancer 45:1547–1553CrossRefGoogle Scholar
  3. 3.
    Beck-Fruchter R, Weiss A, Shalev E (2008) GnRH agonist therapy as ovarian protectants in female patients undergoing chemotherapy: a review of the clinical data. Hum Reprod Update 14:553–561CrossRefPubMedGoogle Scholar
  4. 4.
    Badawy A, Elnashar A, El-Ashry M, Shahat M (2009) Gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage: prospective randomized study. Fertil Steril 9:694–697CrossRefGoogle Scholar
  5. 5.
    Ismail-Khan R, Minton S, Cox C et al (2008) Preservation of ovarian function in young women treated with neoadjuvant chemotherapy for breast cancer: a randomized trial using GnRH agonist (triptoreline) during chemotherapy. J Clin Oncol 26(Suppl 1):12s Abstract 524Google Scholar
  6. 6.
    Gerber B, Dieterich M (2010) Ovarielle Protektion unter Chemotherapie durch GnRH-Agonisten. Gynäkologische Endokrinologie 1:41–46CrossRefGoogle Scholar
  7. 7.
    Behringer K, Wildt L, Mueller H, Mattle V, Ganitis P, van den Hoonaard B, Ott HW, Hofer S, Pluetschow A, Diehl V, Engert A, Borchmann P, on behalf of the German Hodgkin Study Group (2010) No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group. Ann Oncol. doi: 10.1093/annonc/mdq066
  8. 8.
    von Wolff M, Zeeb C, Lawrenz B, Germeyer A., Neunhoeffer E, Strowitzki T (2009) Cryopreservation of ovarian tissue and cryopreservation of oocytes can be efficiently combined and performed within 2 weeks before chemotherapy. Hum Reprod 24(1) Abstract Book P-392Google Scholar
  9. 9.
    von Wolff M, Thaler CJ, Frambach T, Zeeb C, Lawrenz B, Popovici RM, Strowitzki T (2009) Ovarian stimulation to cryopreserve fertilized oocytes in cancer patients can be started in the luteal phase. Fertil Steril 92:1360–1365CrossRefGoogle Scholar
  10. 10.
    Azim AA, Costantini-Ferrando M, Lostritto K, Oktay K (2007) Relative potencies of anastrozole and letrozole to suppress estradiol in breast cancer patients undergoing ovarian stimulation before in vitro fertilization. J Clin Endocrinol Metab 92:2197–2200CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Michael von Wolff
    • 1
    Email author
  • Juliane Raddatz
    • 2
  • Michael K. Bohlmann
    • 3
  • Petra Stute
    • 1
  • Thomas Strowitzki
    • 2
  • Markus Nitzschke
    • 1
  1. 1.Department of Gynecological Endocrinology and Reproductive MedicineWoman’s University Hospital of BernBernSwitzerland
  2. 2.Department of Gynecological Endocrinology and Reproductive MedicineWoman’s University Hospital of HeidelbergHeidelbergGermany
  3. 3.Department of Obstetrics and GynecologyUniversity Hospital of Schleswig–HolsteinLuebeckGermany

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