Leuprorelin acetate for the preservation of ovarian function in premenopausal women with neoplastic disease undergoing chemotherapy
Ovarian failure resulting in infertility is a common toxic effect of chemotherapy in cancer patients treated during their reproductive years. Chemotherapy causes premature ovarian failure due to impaired ovarian follicular maturation and/or direct immature follicle loss. The extent of damage depends on the age and pre-treatment ovarian reserve of the patient, and the type and dose of chemotherapy administered. Current options to preserve fertility in young patients who must undergo chemotherapy include cryopreservation strategies (‘egg freezing’) which can often be complicated and costly.
Leuprorelin acetate is a gonadotropin-releasing hormone (GnRH) analogue that may preserve ovarian function by preventing early stage development of ovarian follicles from maturation. This may decrease the number of follicles that are vulnerable to chemotherapy. The protective effects of GnRH analogues have also been associated with a decrease in utero-ovarian blood flow which leads to decreased exposure of the ovaries to the chemotherapeutic agents. If licensed, leuprorelin acetate, given by injection, may offer a simpler, less invasive and less expensive alternative when compared to current strategies for preserving ovarian function in women undergoing chemotherapy.