Human Reproduction Archives
Human Reproduction Archives
Review Article Assisted Reproduction

Use of Gosereline in the preservation of fertility in young women with breast cancer: a bibliographical review

Flávio Chagas de Albuquerque, Iolanda Matias Gomes, Luiz Alberto Mattos, Márcia Silva de Oliveira

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The fertility preservation in cancer patients is a concern that mobilizes researchers worldwide, since ovarian failure after chemotherapy is an important issue. Several methods have been developed to increase the chances of pregnancy after cancer treatment, such as the use of Gosereline, a Gonadotrophin-Releasing Hormone Agonist adjuvant to chemotherapy, for ovarian protection. A review of the literature was done, and after exclusion criteria, eight studies were selected. In general, all evaluated studies discusses that Goserelin is a good option for reducing the risk of premature ovarian failure, since it is able to preserves ovarian function. Moreover, GnRH agonist used concomitantly with chemotherapy in a breast cancer patient appears to protect against the harmful effects of chemotherapy, with a high probability of pregnancy, improved fertility and long-term survival. Nevertheless, all studies agree that further prospective and randomized studies are required.


GnRH agonist; fertility preservation; ovarian failure; chemotherapy


1. Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2016: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2015 [cited 2016 July]. Available from:

2. Yoshida K, Miki Y. Role of BRCA1 and BRCA2 as regulators of DNA repair, transcription, and cell cycle in response to DNA damage. Cancer Sci. 2004;95(11):866-71.

3. Silva HMS, Junqueira JPC, Pacheco F, Megale L, Poggiale P. Gravidez depois dos 40. Belo Horizonte; 2004 [cited 2007 May 20]. Available from:

4. Freitas F, Martins-Costa SH, Ramos JGL, Magalhães JA. Rotinas em obstetrician. 6th ed. Porto Alegre: Art Med; 2011.

5. Urruticoechea A, Arnedos M, Walsh G, Dowsett M, Smith IE. Ovarian protection with goserelin during adjuvant chemotherapy for pre-menopausal women with early breast cancer (EBC). Breast Cancer Res Treat. 2008;110(3):411-6.

6. Maltaris T, Seufert R, Fischl F, Schaffrath M, Pollow K, Koelbl H, et al. The effect of cancer treatment on female fertility and strategies for preserving fertility. Eur J Obstet Gynecol Reprod Biol. 2007;130(2):148-55.

7. De Vet A, Laven JSE, de Jong FH, Themmen APN, Fauser BCJM. Antimüllerian hormone serum levels: a putative marker for ovarian aging. Fertil Steril. 2002;77(2):357-62.

8. Avril C. L’ovocyte: avancées fondamentales et thérapeutiques: peut-on prédire la qualité ovocytaire par l’échographie? J Gynecol Obstet Biol Reprod. 2006;35(2):42-3.

9. Chuang CC, Chen CD, Chao KH, Chen SU, Ho HN, Yang YS. Age is a better predictor of pregnancy potential than basal folliclestimulating hormone levels in women undergoing in vitro fertilization. Fertil Steril. 2003;79(1):63-8.

10. Seifer DB, MacLaughlin DT. Mullerian Inhibiting Substance in an ovarian growth factor or emerging clinical significance. Fertil Steril. 2007;88(3):539-46.

11. Visser JA, de Jong FH, Laven JSE, Themmen APN. Anti-Müllerian hormone: a new marker for ovarian function. Reproduction. 2006;131(1):1-9.

12. Maheshwari A, Fowler P, Bhattacharya S. Assessment of ovarian reserve – should we perform tests of ovarian reserve routinely? Hum Reprod. 2006;21(11):2729-35.

13. Tufan E, Elter K, Durmusoglu F. Assessment of reproductive ageing patterns by hormonal and ultrasonographic ovarian reserve tests. Hum Reprod. 2004;19(11):2484-9.

14. Kovacs P. Preserving ovarian function after breast cancer treatment. Fertil Steril. 2009;91(3):694-7.

15. Brougham MF, Wallace WHB. Subfertility in children and young people treated for solid and haematological malignancies. Br J Haematol. 2005;131(2):143-55.

16. Del Mastro L, Catzeddu T, Boni L, Bell C, Sertoli MR, Bighin C, et al. Prevention of chemotherapy induced menopause by temporary ovarian suppression with goserelin in young, early breast cancer patients. Ann Oncol. 2006;17(1):74-8.

17. Wallace WH, Kelsey TW. Ovarian reserve and reproductive age may be determined from measurement of ovarian volume by transvaginal sonography. Hum Reprod. 2004;19(7):1612-7.

18. Chang HJ, Suh CS. Fertility preservation for women with malignancies: current developments of crypreservation. J Gynecol Oncol. 2008;19(2):99-107.

19. Blumenfeld Z. GnRH-agonists in fertility preservation. Curr Opin Endocrinol Diabetes Obes. 2008;15(6):523-8.

20. Chen SV, Yang YS. Slow freezing or vitrification of oocytes: their effects on survival and meiotic spindles, and the time schedule for clinical practice. Taiwan J Obstet Gynecol. 2009;48(1):15-20.

21. Maltaris T, Beckmann MW, Dittrich R. Fertility preservation for young female cancer patients. In Vivo. 2009;23(1):123-30.

22. Georgescu ES, Goldberg JM, du Plessis SS, Agarwal A. Present and future fertility preservation strategies for female cancer patients. Obstet Gynecol Surv. 2008;63(11):725-32.

23. Cabrera R, Stadtmauer L, Mayer J, Gibbons W, Oehninger S. Follicular phase serum levels of luteinizing hormone do not influence delivery rates in in vitro fertilization cycles down-regulated with a gonadotropin-releasing hormone agonist and stimulated with recombinant follicle-stimulating hormone. Fertil Steril. 2005;83(1):42-8.

24. Sonmezer M, Oktay K. Fertility preservation in female patients. Hum Reprod Update. 2004;10(3):251-66.

25. Albain K, Barlow W, O’Malley F, Siziopikou K, Yeh IT, Ravdin P, et al. Concurrent (CAFT) versus sequential (CAF-T) chemohormonal therapy (cyclophosphamide, doxorubicin, 5-fluorouracil, tamoxifen) versus T alone for postmenopausal, node-positive, estrogen (ER) and/or progesterone (PgR) receptor-positive breast cancer: mature outcomes and new biologic correlates on phase III intergroup trial 0100 (SWOG-8814). In: Proceedings of the San Antonio Breast Cancer Symposium; 2004; San Antonio, Texas, USA. Texas: SABCS; 2004.

26. Baum M, Hackshaw A, Houghton J, Rutqvist, Fornander T, Nordenskjold B, et al. Adjuvant goserelin in premenopausal patients with early breast cancer: results from the ZIPP study. Eur J Cancer. 2006;42(7):895-904.

27. Badawy A, Elnashar A, El-Ashry M, Shahat M. Gonadotropin-releasing hormone agonists for prevention of chemotherapy-induced ovarian damage: prospective randomized study. Fertil Steril. 2009;91(3):694-7.

28. Gerber B, Stehle H, Ricardo F, Maass N, Fischer D, Sommer HL, et al. ZORO: a prospective randomized multicenter study to prevent chemotherapy-induced ovarian failure with the GnRH-agonist goserelin in young hormone-insensitive breast cancer patients receiving anthracycline containing (neo-)-adjuvant chemotherapy (GBG 37). J Clin Oncol. 2009;15(Suppl):526.

29. Sverrisdottir A, Nystedt M, Johansson H, Fornander T. Adjuvant goserelin and ovarian preservation in chemotherapy treated patients with early breast cancer: results from a randomised trial. Breast Cancer Res Treat. 2009;117(3):561-7.

30. Oktay K, Buyuk E, Libertella N, Akar M, Rosenwaks Z. Fertility preservation in breast cancer patients: a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for embryo cryopreservation. J Clin Oncol. 2005;23(19):4347-53.

31. Petru E. Fertility preservation and infertility treatment in breast cancer patients. Wien Med Wochenschr. 2010;160(19-20):487-92.

32. Wong M, O’Neill S, Walsh G, Smith IE. Goserelin with chemotherapy to preserve ovarian function in pre-menopausal women with early breast cancer: menstruation and pregnancy outcomes. Ann Oncol. 2013;24(1):133-8.

33. Kim J, Kim M, Lee JH, Lee H, Lee SK, Bae SY, et al. Ovarian function preservation with GnRH agonist in young breast cancer patients: does it impede the effect of adjuvant chemotherapy? Breast. 2014;23(5):670-5.

34. Recchia F, Necozione S, Bratta M, Rosselli M, Guerriero G, Rea S. LH-RH analogues in the treatment of young women with early breast cancer: long-term follow-up of a phase II study. Int J Oncol. 2015;46(3):1354-60.

35. Del Mastro L, Rossi G, Lambertini M, Poggio F, Pronzato P. New insights on the role of luteinizing hormone releasing hormone agonists in premenopausal early breast cancer patients. Cancer Treat Rev. 2016;42:18-23.

36. Moore HC, Unger JM, Phillips KA, Boyle F, Hitre E, Porter D, et al. POEMS/S0230 Investigators. Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy. N Engl J Med. 2015;372(10):923-32.

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