Purpose: Ovarian failure and infertility following adjuvant chemotherapy for early breast cancer are major concerns for some young
women. Techniques for oocyte harvesting are associated with delay in starting treatment, potentially undesirable estrogen
stimulation and a relatively low success rate. We report an audit of our experience with the luteinising hormone-releasing
hormone agonist, goserelin, to achieve transient ovarian suppression during chemotherapy as a means of preserving ovarian
function.
Patient and methods: Pre-menopausal women were offered goserelin 3.6 mg by subcutaneous injection every 28 days during chemotherapy, starting
0–14 days prior to treatment. The primary end-point was recovery of menstruation. Serum luteinising hormone, follicle stimulating
hormone and oestradiol were measured at recovery of menstruation or at first year follow-up if amenorrhoea persisted. Subsequent
pregnancies were recorded.
Results: Fifty-one evaluable women were audited. Amenorrhoea occurred in all but one. All received combination anthracycline-containing
chemotherapy regimens with a mean cumulative cyclophosphamide dose of 3.9 g/m
2. Forty-five (90%) recovered menstruation during the first year of follow-up; mean time to recovery 5 months. Eight pregnancies
in 10 women attempting this so far.
Conclusion: Using goserelin concurrently with chemotherapy is associated with a high rate of ovarian function preservation.
Keywords Ovarian protection - Goserelin - Adjuvant chemotherapy - Early breast cancer