Assessment of ovarian reserve following ovarian tissue banking and/or GnRH-a co-treatment prior to chemotherapy in patients with Hodgkin’s disease

  • Foad Azem
  • Nivin Samara
  • Tanya Cohen
  • Dalit Ben-Yosef
  • Beni Almog
  • Joseph B. Lessing
  • Odeliya Goor
  • Ami Amit
GENERAL INFERTILITY

Abstract

Purpose

To examine ovarian reserve following chemotherapy in women with Hodgkin’s disease.

Methods

The study included nine patients who underwent ovarian tissue cryopreservation (OTCP) prior to chemotherapy consisting of the ABVD regimen (Adriamycin, bleomycin, vinblastine, and dacarbazine) and co-treatment with gonadotropin-releasing hormone agonist (GnRH-a) (Group A), and 13 patients treated by the ABVD protocol only without GnRH-a (Group B). The average age was 25.2 ± 2.7 years for the women in Group A and 31.8 ± 6.8 years for those in Group B.

Results

Six months following the end of chemotherapy, the menstrual cycle resumed in all Group A patients and in four Group B patients who had amenorrhea. Eight Group B patients had regular menses during and after chemotherapy. None of the patients suffered from ovarian failure. Two Group A patients conceived in the first year after completing chemotherapy.

Conclusions

Co-treatment with GnRH-a has little effect on ovarian protection in women with Hodgkin’s disease.

Keywords

Hodgkin’s disease Chemotherapy Ovarian tissue cryopreservation GnRH-a Ovarian reserve 

References

  1. 1.
    Kogel KE, Sweetenham JW. Current therapies in Hodgkin’s disease. Eur J Nucl Med Mol Imaging. 2003;30(Suppl 1):S19–27.PubMedGoogle Scholar
  2. 2.
    Canellos GP, Anderson JR, Propert KJ, Nissen N, Cooper MR, Henderson ES, et al. Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD or MOPP alternating with ABVD. N Engl J Med. 1992;327:1478.PubMedGoogle Scholar
  3. 3.
    Blumenfeld Z, Haim N. Prevention of gonadal damage during cytotoxic therapy. Ann Med. 1997;29:199–206. doi:10.3109/07853899708999337.PubMedCrossRefGoogle Scholar
  4. 4.
    Waxman JH, Ahmed R, Smith D, Wrigley PF, Gregory W, Shalet S. Failure to preserve fertility in patients with Hodgkin’s disease. Cancer Chemother Pharmacol. 1987;19:159–62. doi:10.1007/BF00254570.PubMedCrossRefGoogle Scholar
  5. 5.
    Oktay K, Sonmerz M. Ovarian tissue banking, not just ovarian cryopreservation. Hum Reprod. 2004;19:477–80. doi:10.1093/humrep/deh152.PubMedCrossRefGoogle Scholar
  6. 6.
    Gosden RG, Wade JC, Fraser HM, Sandow J, Faddy MJ. Impact of congenital or experimental hypogonadotropism on radiation sensitivity of the mouse ovary. Hum Reprod. 1997;12:2483–8. doi:10.1093/humrep/12.11.2483.PubMedCrossRefGoogle Scholar
  7. 7.
    Azem F, Yovel I, Wagman I, Kapostiansky R, Lessing JB, Amit A. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries. Fertil Steril. 2003;79:1229–30. doi:10.1016/S0015-0282(03)00148-1.PubMedCrossRefGoogle Scholar
  8. 8.
    Porcu E, Venturoli S. Progress with oocyte cryopreservation. Curr Opin Obstet Gynecol. 2006;18:273–9. doi:10.1097/01.gco.0000193015.96275.2d.PubMedCrossRefGoogle Scholar
  9. 9.
    Meirow D, Levron J, Eldar-Geva T, Hardan I, Frideman E, Zalel Y, Schiff E, Dor J. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005;353:318–21. doi:10.1056/NEJMc055237.PubMedCrossRefGoogle Scholar
  10. 10.
    Bukman A, Heineman MJ. Ovarian reserve testing and the use of prognostic models in patients with subfertility. Hum Reprod Update. 2001;7:581–90. doi:10.1093/humupd/7.6.581.PubMedCrossRefGoogle Scholar
  11. 11.
    Bukulmetz O, Arici A. Assessment of ovarian reserve. Curr Opin Obstet Gynecol. 2004;16:231–7. doi:10.1097/00001703-200406000-00005.CrossRefGoogle Scholar
  12. 12.
    van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, de Jong FH, Themmen AP. Serum anti mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod. 2002;17:3065–71. doi:10.1093/humrep/17.12.3065.PubMedCrossRefGoogle Scholar
  13. 13.
    Ficicioglu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimullerian hormone as an indicator of ovarian reserve. Fertil Steril. 2006;85:592–6. doi:10.1016/j.fertnstert.2005.09.019.PubMedCrossRefGoogle Scholar
  14. 14.
    La Marca A, Volpe A. Anti mullerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool? Clin Endicrinoligy. 2006;64:603–10. doi:10.1111/j.1365-2265.2006.02533.x.CrossRefGoogle Scholar
  15. 15.
    Ebner T, Sommergruber M, Moser M, Shebl O, Schreier-Lechner E, Tews G. Basal level of anti mullerian hormone is associated with oocyte quality in stimulated cycles. Hum Reprod. 2006;21:2022–6. doi:10.1093/humrep/del127.PubMedCrossRefGoogle Scholar
  16. 16.
    Gosden RG, Baird DT, Wade JC, Webb R. Restoration of fertility to oophoroctomized sheep by ovarian autografts stored at −196°C. Hum Reprod. 1994;9:597–603.PubMedGoogle Scholar
  17. 17.
    Pacheco BP, Mendez Ribas JM, Milone G, Fernandez I, Kvicala R, Mila T, Di Noto A, Ortiz OC, Pavlovsky S. Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report. Gynecol Oncol. 2001;81:391–7. doi:10.1006/gyno.2001.6181.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Foad Azem
    • 1
  • Nivin Samara
    • 1
  • Tanya Cohen
    • 1
  • Dalit Ben-Yosef
    • 1
  • Beni Almog
    • 1
  • Joseph B. Lessing
    • 1
  • Odeliya Goor
    • 1
  • Ami Amit
    • 1
  1. 1.Racine IVF Unit, Lis Maternity Hospital, Institute of Hematology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael

Personalised recommendations