Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;10(7):409.
doi: 10.21037/atm-22-928.

Ovarian protection and safety of gonadotropin-releasing hormone agonist after cervical cancer surgery: systematic review and meta-analysis

Jialing Yuan  1   2 , Yi Lai  1   2 , Tao Li  1   2
Affiliations

Ovarian protection and safety of gonadotropin-releasing hormone agonist after cervical cancer surgery: systematic review and meta-analysis

Jialing Yuan et al. Ann Transl Med. 2022 Apr.

Abstract

Background: This meta-analysis was performed using Stata (15.0), and sought to systematically evaluate the domestic application value of the gonadotropin-releasing hormone agonist (GNRH-a) after cervical cancer, and explore its protective effect on the ovaries during chemotherapy. In many studies, the effectiveness and safety of GNRH-a are not consistent, and there is great controversy. Therefore, it is very important to systematically evaluate the protection and safety of GNRH-a after cervical cancer surgery.

Methods: PubMed, Cochrane Library, and Web of Science databases were systematically searched to retrieve articles on domestic trials examining the use of GNRH-a treatment in cervical cancer patients, published from January 2014 to January 2021, which were reviewed according to the inclusion and exclusion criteria of this study. The meta-analysis of the included study data was conducted using Stata 15.0.

Results: In total, 10 articles were included in the meta-analysis, comprising 579 ovarian-reserved cervical cancer subjects, all of whom received 4-6 standardized courses of PC (Paclitaxel + Cisplatin) chemotherapy. The following statistically significant differences were found: bovine follicle stimulating hormone [odds ratio (OR) =1.82, 95% confidence interval (CI): 1.38-2.38; P<0.0001], bovine estrogen 2 (OR =2.39, 95% CI: 1.69-3.37; P<0.00001), anti-Mullerian hormone (OR =2.39, 95% CI: 1.71-3.34; P<0.00001), and bovine antral follicle count (OR =2.11, 95% CI: 1.49-2.99; P<0.0001); but there is no statistically significant difference incidence of coincidences (OR =0.80, 95% CI: 0.49-1.31; P=0.38).

Conclusions: The use of GNRH-a in cervical cancer patients receiving the PC chemotherapy regimen plays a significant role in protecting ovarian function.

Keywords: Gonadotropin-releasing hormone agonist (GNRH-a); cervical cancer; meta-analysis; ovarian protection; systematic review.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-928/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of the article screening process.
Figure 2
Figure 2
Literature quality evaluation chart. (A) Risk of bias graph; (B) risk of bias summary. +, low risk of bias; −, high risk of bias; ?, unclear risk of bias.
Figure 3
Figure 3
Funnel plots of literature publication bias. OR, odds ratio; SE, standard error.
Figure 4
Figure 4
Meta-analysis comparing bFSH levels between the two groups. bFSH, bovine follicle stimulating hormone; OR, odds ratio; +, low risk of bias; −, high risk of bias; ?, unclear risk of bias.
Figure 5
Figure 5
Meta-analysis comparing bE2 levels between two groups. bE2, bovine estrogen 2; OR, odds ratio; +, low risk of bias; −, high risk of bias; ?, unclear risk of bias.
Figure 6
Figure 6
Meta-analysis comparing AMH levels between two groups. AMH, anti-Mullerian hormone; OR, odds ratio; +, low risk of bias; −, high risk of bias; ?, unclear risk of bias.
Figure 7
Figure 7
Meta-analysis comparing bAFC levels between two groups. bAFC, bovine antral follicle count; OR, odds ratio; +, low risk of bias; −, high risk of bias; ?, unclear risk of bias.
Figure 8
Figure 8
Meta-analysis of incidence of coincidences between two groups. OR, odds ratio; +, low risk of bias; −, high risk of bias; ?, unclear risk of bias.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Castillo JC, Haahr T, Martínez-Moya M, et al. Gonadotropin-releasing hormone agonist ovulation trigger-beyond OHSS prevention. Ups J Med Sci 2020;125:138-43. 10.1080/03009734.2020.1737599 - DOI - PMC - PubMed
    1. Castillo JC, Haahr T, Martínez-Moya M, et al. Gonadotropin-releasing hormone agonist for ovulation trigger - OHSS prevention and use of modified luteal phase support for fresh embryo transfer. Ups J Med Sci 2020;125:131-7. 10.1080/03009734.2020.1736696 - DOI - PMC - PubMed
    1. Driancourt MA, Briggs JR. Gonadotropin-Releasing Hormone (GnRH) Agonist Implants for Male Dog Fertility Suppression: A Review of Mode of Action, Efficacy, Safety, and Uses. Front Vet Sci 2020;7:483. 10.3389/fvets.2020.00483 - DOI - PMC - PubMed
    1. Hershko Klement A, Navve D, Ghetler Y, et al. Gonadotropin releasing hormone agonist triggering for in vitro maturation cycles. Hum Fertil (Camb) 2020. [Epub ahead of print]. - PubMed
    1. Lin MH, Wu FS, Hwu YM, et al. Dual trigger with gonadotropin releasing hormone agonist and human chorionic gonadotropin significantly improves live birth rate for women with diminished ovarian reserve. Reprod Biol Endocrinol 2019;17:7. 10.1186/s12958-018-0451-x - DOI - PMC - PubMed