Endocrine Abstracts

JOINT3752

Introduction: The use of GnRH analogues aims to protect ovarian function during chemotherapy. While its effectiveness remains controversial, it may help reduce the risk of premature ovarian failure. However, its long-term impact on spontaneous pregnancy rates is still uncertain.

Objective: To determine the ovarian function and follicular reserve in patients who received treatment with GnRH analogues (GnRHa) during chemotherapy.

Population and Methods: Patients with a history of oncological disease in the childhood-juvenile stage treated at the Professor Alejandro Posadas National Hospital were studied between 11/01/2020 and 10/31/2022 by determining AMH, antral follicle count and FSH levels. The participants were recruited during the follow-up of cancer treatment. Descriptive statistics were presented.

Results: Of 31 pubertal patients, 16 completed the analogue treatment, 9 did not complete the treatment, and 6 did not receive it. The median age at the start of oncological treatment was 13. 1 years (8. 1–17. 6), at the end 14. 9 years (10. 2–20. 3) and at evaluation 23. 1 years (14. 8–31. 9). The median follow-up period was 8. 4 years (5–20. 3). The diagnosis was: 15 ALL; 4 AML; 7 Hodgkin’s Lymphoma; 3 Non-Hodgkin’s Lymphoma; 2 Ovarian Dysgerminoma. 7 patients had FSH values ≥25 mIU/mL (3 completed GnRHa treatment, 2 had incomplete treatment, and 2 did not receive it). 3 evidenced ALL (20%); 3 AML (75%); 1 Hodgkin’s Lymphoma (14. 3%). 10 patients had AMH values <1 ng/ml (3 completed GnRHa treatment, 3 incomplete treatment and 4 did not receive it). 4 evidenced ALL (26. 7%); 4 AML (100%); 1 Hodgkin lymphoma (14. 3%); 1 ovarian dysgerminoma (50%). AMH levels <1 ng/mL and/or FSH ≥25 mIU/mL were observed in 3 of 13 with chemotherapy (QMT) alone, 1 of 6 with QMT + radiotherapy (RT), 1 of 5 with QMT + surgery (CX), 1 with QMT + BMT (bone marrow transplant) + CX, and all 4 with QMT + RT + BMT The median AMH was 2. 1 ng/ml (0. 1-4. 8) for those with complete GnRHa treatment, 1. 9 ng/ml (0. 1-6. 5) for incomplete treatment, and 0. 7 ng/ml (0. 1-2. 5) for no treatment. The median FSH was 7. 7 mUI/ml (4. 9-200) with complete treatment, 28. 7 mUI/ml (5. 1-70) with incomplete treatment, and 14. 0 mUI/ml (7. 7-123. 3) without treatment.

Conclusion: There does not seem to be any differences in ovarian function or follicular reserve in these cases; however, Conclusions should be drawn based on a sufficient sample size. The impact on fertility would be closely related to the therapy received.