Skip to main content

Advertisement

SpringerLink
Log in

Failure of ovarian ablation with goserelin in a pre-menopausal breast cancer patient resulting in pregnancy: a case report and review of the literature

  • Brief Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

To report an unanticipated pregnancy during ovarian ablation treatment with goserelin (10.8 mg SC every 12 weeks) in a 26-year old female with breast cancer. Review of the current literature and reports in MEDLINE, PubMED, and EMBASE using searches with keywords “goserelin, pregnancy, breast cancer, breast neoplasms, fertility, ovarian ablation, gonadotropin releasing hormone agonists/analogs, leuprolide, pregnancy complications, teratogens” (July–September 2010). Only 3 other reports of failures with goserelin administration at ablative doses in breast cancer patients were discovered. For physicians and breast cancer patients using a GnRH analog, it is important to be aware of the possibility of inadequate ovarian function suppression and the potential for pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. 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 91(3):694–697

    Article  PubMed  CAS  Google Scholar 

  2. Neal MS, Di Paolo L, Willoughby K, Faghih M, Karnis M, Hughes EG et al (2008) Fertility preservation for young women with cancer: Hope for the future. Current Women’s Health Reviews 4(4):258–265

    Article  Google Scholar 

  3. Sverrisdottir A, Nystedt M, Johansson H, Fornander T (2009) Adjuvant goserelin and ovarian preservation in chemotherapy treated patients with early breast cancer: results from a randomized trial. Breast Cancer Res Treat 117(3):561–567

    Article  PubMed  CAS  Google Scholar 

  4. Urruticoechea A, Arnedos M, Walsh G, Dowsett M, Smith IE (2008) Ovarian protection with goserelin during adjuvant chemotherapy for pre-menopausal women with early breast cancer (EBC). Breast Cancer Res Treat 110(3):411–416

    Article  PubMed  CAS  Google Scholar 

  5. Carlson RW, Theriault R, Schurman CM, Rivera E, Chung CT, Phan SC et al (2010) Phase II trial of anastrozole plus goserelin in the treatment of hormone receptor-positive, metastatic carcinoma of the breast in premenopausal women. J Clin Oncol 28(25):3917–3921

    Article  PubMed  CAS  Google Scholar 

  6. Jimenez-Gordo AM, De las Heras B, Zamora P, Espinosa E, Gonzalez-Baron M (2000) Failure of goserelin ovarian ablation in premenopausal women with breast cancer: two case reports. Gynecol Oncol 76(1):126–127

    Article  PubMed  CAS  Google Scholar 

  7. Vandenput I, Vergote I, Amant F, Neven P, Paridaens R, Christiaens MR (2006) Aromatase inhibitors in premenopausal women: the need for proper contraceptive counseling. Breast J 12(5):507–508

    Article  PubMed  Google Scholar 

  8. Cockshott ID (2000) Clinical pharmacokinetics of goserelin. Clin Pharmacokinet 39(1):27–48

    Article  PubMed  CAS  Google Scholar 

  9. Study to Compare ZoladexTM 10.8 mg with zoladex 3.6 mg in pre-menopausal women with breast cancer. 2010. http://clinicaltrials.gov/ct2/show/NCT01073865. Accessed September 11, 2010

  10. Taskin O, Gokdeniz R, Atmaca R, Burak F (1999) Normal pregnancy outcome after inadvertent exposure to long-acting gonadotrophin-releasing hormone agonist in early pregnancy. Hum Reprod 14(5):1368–1371

    Article  PubMed  CAS  Google Scholar 

  11. Friedman JM (1988) Teratogen update: anesthetic agents. Teratology 37(1):69–77

    Article  PubMed  CAS  Google Scholar 

  12. Kallen B, Mazze RI (1990) Neural tube defects and first trimester operations. Teratology 41(6):717–720

    Article  PubMed  CAS  Google Scholar 

  13. Sylvester GC, Khoury MJ, Lu X, Erickson JD (1994) First-trimester anesthesia exposure and the risk of central nervous system defects: A population-based case-control study. Am J Public Health 84(11):1757–1760

    Article  PubMed  CAS  Google Scholar 

  14. Meirow D, Epstein M, Lewis H, Nugent D, Gosden RG (2001) Administration of cyclophosphamide at different stages of follicular maturation in mice: effects on reproductive performance and fetal malformations. Hum Reprod 16(4):632–637

    Article  PubMed  CAS  Google Scholar 

  15. Falcone T, Attaran M, Bedaiwy MA, Goldberg JM (2004) Ovarian function preservation in the cancer patient. Fertil Steril 81(2):243–257

    Article  PubMed  Google Scholar 

  16. Antypas C, Sandilos P, Kouvaris J, Balafouta E, Karinou E, Kollaros N et al (1998) Fetal dose evaluation during breast cancer radiotherapy. Int J Radiat Oncol Biol Phys 40(4):995–999

    Article  PubMed  CAS  Google Scholar 

  17. Mazonakis M, Varveris H, Damilakis J, Theoharopoulos N, Gourtsoyiannis N (2003) Radiation dose to conceptus resulting from tangential breast irradiation. Int J Radiat Oncol Biol Phys 55(2):386–391

    Article  PubMed  Google Scholar 

  18. Fenig E, Mishaeli M, Kalish Y, Lishner M (2001) Pregnancy and radiation. Cancer Treat Rev 27(1):1–7

    Article  PubMed  CAS  Google Scholar 

  19. Balasch J, Tur R, Creus M, Buxaderas R, Fabregues F, Ballesca JL et al (1994) Triggering of ovulation by a gonadotropin releasing hormone agonist in gonadotropin-stimulated cycles for prevention of ovarian hyperstimulation syndrome and multiple pregnancy. Gynecol Endocrinol 8(1):7–12

    Article  PubMed  CAS  Google Scholar 

  20. Breckwoldt M, Geisthovel F, Neulen J, Schillinger H (1988) Management of multiple conceptions after gonadotropin-releasing hormone analog/human menopausal gonadotropin/human chorionic gonadotropin therapy. Fertil Steril 49(4):713–715

    PubMed  CAS  Google Scholar 

  21. Carrera J, Estrada L, Sarquella J, Soriano P (2002) Effect of the addition of GnRH agonist (leuprolide acetate) to FSHr in the protocols of ovarian stimulation for artificial insemination cycles. Revista Iberoamericana de Fertilidad y Reproduccion Humana 19(2):109–114

    Google Scholar 

  22. Ghazi DM, Kemmann E, Hammond JM (1991) Normal pregnancy outcome after early maternal exposure to gonadotropin releasing hormone agonist. A case report. J Reprod Med 36(3):173–174

    PubMed  CAS  Google Scholar 

  23. Pickersgill A, Kingsland CR, Garden AS, Farquharson RG (1994) Multiple gestation following gonadotrophin releasing hormone therapy for the treatment of minimal endometriosis. Br J Obstet Gynaecol 101(3):260–262

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cancer Centre of Southeastern Ontario, 25 King Street West, Kingston, ON, K7L 5P9, Canada

    N. Hill & Y. Madarnas

Authors
  1. N. Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y. Madarnas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y. Madarnas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hill, N., Madarnas, Y. Failure of ovarian ablation with goserelin in a pre-menopausal breast cancer patient resulting in pregnancy: a case report and review of the literature. Breast Cancer Res Treat 129, 265–268 (2011). https://doi.org/10.1007/s10549-011-1542-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-011-1542-y

Keywords

Search

Navigation