Université de Paris, AP-HP. Nord Université de Paris, Hôpital Universitaire Robert-Debré, Service d'Endocrinologie Diabétologie Pédiatrique et Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris, France.
NeuroDiderot, INSERM, Université de Paris, Paris, France.
Horm Res Paediatr. 2020;93(9-10):529-538. doi: 10.1159/000513702. Epub 2021 Mar 26.
Gonadotropin-releasing hormone analogues (GnRHa) administered as depot formulations are the standard of care for children with central precocious puberty (CPP). Puberty resumes after treatment discontinuation, but little is known concerning fertility in women who have been treated with GnRHa for CPP during childhood.
The PREFER (PREcocious puberty, FERtility) study prospectively analysed fertility, via a series of questionnaires, in women treated during childhood with triptorelin (depot formulation) for CPP. Co-primary endpoints were the proportion of women wanting a pregnancy any time before study inclusion and during the follow-up period but not pregnant 6 and 12 months after stopping contraception and the waiting time to pregnancy (WTP).
A total of 574 women were identified, and 194 women were included in the analysis. Although there were not enough data for primary endpoint assessment, few women (1.7%) reported issues with fertility or were unable to become pregnant despite trying to conceive. Most pregnancies (84.4%, 95% CI [67.2-94.7%]) occurred within 1 year of trying to conceive, in line with the WTP for women without previous CPP.
The results, based on a limited sample of patients, suggest that CPP treated with triptorelin does not negatively impact women's fertility in adulthood. These results need to be consolidated with a subsequent study performed when these women will have reached their mid-thirties.
作为长效制剂给予的促性腺激素释放激素类似物(GnRHa)是治疗中枢性性早熟(CPP)儿童的标准治疗方法。治疗停止后青春期会恢复,但对于在儿童期接受 GnRHa 治疗 CPP 的女性的生育能力知之甚少。
PREFER(性早熟、生育力)研究前瞻性地通过一系列问卷分析了接受曲普瑞林(长效制剂)治疗 CPP 的女性的生育能力。主要终点是在研究纳入前和随访期间任何时间都希望怀孕但在停止避孕后 6 个月和 12 个月仍未怀孕的女性比例和妊娠等待时间(WTP)。
共确定了 574 名女性,其中 194 名女性纳入分析。尽管没有足够的数据进行主要终点评估,但很少有女性(1.7%)报告生育问题或尽管尝试怀孕但仍无法怀孕。大多数妊娠(84.4%,95%CI [67.2-94.7%])在尝试怀孕后 1 年内发生,与无 CPP 病史的女性的 WTP 一致。
基于有限数量的患者样本,结果表明曲普瑞林治疗 CPP 不会对女性成年后的生育能力产生负面影响。这些结果需要在这些女性达到三十多岁时进行后续研究来证实。