In JAMA this week, a team of researchers in Italy presents findings from a study of the effects of triptorelin — a gonadotropin-releasing hormone analog — on the occurrence of chemotherapy-induced early menopause in women with breast cancer. To determine if triptorelin's temporary ovarian suppression effect changed the rate of early menopause during chemotherapy, the team studied 281 premenopausal breast cancer patients and randomly assigned them to receive either chemotherapy alone or with triptorelin. The researchers found that the rate of early menopause in the chemotherapy group was 25.9 percent 12 months after chemotherapy was complete, compared to 8.9 percent in the triptorelin group.
Also in JAMA this week, the University of California, San Francisco's Hope Rugo and Mitchell Rosen write that about 35 percent of women newly diagnosed with breast cancer are 54 years or younger, and that 12 percent are younger than 45, making it important for clinicians to address younger patient's concerns about long-term effects of chemotherapy, like loss of fertility and early menopause. Current chemotherapy regimens generally have less ovarian toxicity, the authors write, but recovery of menses can be delayed for up to two years in some women. Gonadotropin-releasing hormone agonists have been thought to protect against chemotherapy-induced "ovarian failure," they add, but the most effective option for preservation of fertility in young female cancer patients is still "assisted reproductive technology with embryo or oocyte cryopreservation." This option should be discussed with and offered to cancer patients before they undergo chemotherapy, Rugo and Rosen write.