Erciyes University, Department of Obstetrics and Gynecology, 38039 Kayseri, Turkey.
Fertil Steril. 2010 Mar 15;93(5):1609-14. doi: 10.1016/j.fertnstert.2009.02.054. Epub 2009 Apr 1.
To evaluate the protective effect of GnRH agonist for the prevention of ovarian reserve during treatment with paclitaxel and cisplatin.
Experimental study.
University-based research laboratory.
ANIMAL(S): Seventy female Wistar-Albino rats.
INTERVENTION(S): Each group consisted of 10 rats. Group 1 served as controls. Groups without GnRH agonist (groups 2, 3, and 4) were administered paclitaxel and cisplatin, respectively; the remaining groups (groups 5, 6, and 7) were given the same regimens with GnRH agonist. The GnRH agonist (leuprolide acetate; 2.5 microg/d subcutaneously for 5 weeks) was started four weeks before chemotherapy to achieve anovulation. Paclitaxel (7.5 mg/kg) and cisplatin (5 mg/kg) were administered intraperitoneally on the 28th day as a single dose.
MAIN OUTCOME MEASURE(S): One week after the chemotherapy, the animals were euthanized and primordial, primary, secondary, and tertiary follicle counts were evaluated.
RESULT(S): Primordial, primary, and tertiary follicle counts in group 5 (paclitaxel plus GnRH agonist) and tertiary follicles in groups 2 and 3 had not decreased, but there was a significant decrease in other treatment groups compared with controls (P < 0.05). Binary comparison between all groups demonstrated that the primordial follicle count in group 5 was comparable to those of the controls.
CONCLUSION(S): Paclitaxel plus GnRH agonist treatment may be an appropriate option for patients deserving further fertility in the preservation of primordial follicles.
评估 GnRH 激动剂在紫杉醇和顺铂治疗中预防卵巢储备功能下降的保护作用。
实验研究。
大学研究实验室。
70 只雌性 Wistar-Albino 大鼠。
每组 10 只大鼠。第 1 组为对照组。未使用 GnRH 激动剂的组(第 2、3 和 4 组)分别给予紫杉醇和顺铂;其余组(第 5、6 和 7 组)给予相同方案加 GnRH 激动剂。 GnRH 激动剂(醋酸亮丙瑞林;皮下 2.5μg/d,共 5 周)在化疗前四周开始,以实现排卵抑制。紫杉醇(7.5mg/kg)和顺铂(5mg/kg)于第 28 天单次腹腔内给药。
化疗后 1 周处死动物,计数原始卵泡、初级卵泡、次级卵泡和三级卵泡数。
第 5 组(紫杉醇加 GnRH 激动剂)的原始卵泡、初级卵泡和三级卵泡计数没有减少,而第 2 和第 3 组的其他治疗组与对照组相比,这些卵泡计数显著减少(P<0.05)。所有组间的二元比较表明,第 5 组的原始卵泡计数与对照组相当。
紫杉醇加 GnRH 激动剂治疗可能是一种适当的选择,适用于需要进一步保留原始卵泡以保持生育能力的患者。