GnRH analogs do not protect ovaries from chemotherapy-induced ultrastructural injury in Hodgkin's lymphoma patients

Purpose: To determine the protective effect of gonadotropin-releasing hormone analogs (GnRHa) using several ultrasound and endocrine markers to detect ultrastructural ovarian damage in Hodgkin's lymphoma patients. Methods: Ten patients who had been treated for Hodgkin's lymphoma and had received GnRHa to protect ovarian function were matched with patients at similar age, who had received the same chemotherapy regimens without GnRHa. In addition, ten healthy women at the same age were matched to the study groups to compare ovarian markers. Blood samples were drawn to determine anti-Müllerian hormone, Inhibin B, follicle-stimulating hormone and transvaginal ultrasound scans were performed to determine antral follicle count and ovarian volume. All women were asked about their menstrual cycle pattern. Results: No difference was found when comparing the ovarian parameters of both study groups. Compared with healthy women, all ovarian parameters in the Hodgkin's lymphoma patients were significantly different. Conclusions: The results of this study demonstrate ultrastructural ovarian damage in Hodgkin's lymphoma patients irrespective of GnRHa co-treatment. These findings do not support previous studies, showing GnRHa to protect ovarian function.