PICO's en zoekverantwoording

#

Reference

In- or Exclusion and reason

1

Anderson RA, Cameron DA. Pretreatment serum anti-mullerian hormone predicts long-term ovarian function and bone mass after chemotherapy for early breast cancer. The Journal of clinical endocrinology and metabolism. 2011; 96: 1336-43.

Exclusion, since ovarian function is outcome

2

Anderson RA, Rosendahl M, Kelsey TW, Cameron DA. Pretreatment anti-Mullerian hormone predicts for loss of ovarian function after chemotherapy for early breast cancer. European journal of cancer (Oxford, England : 1990). 2013; 49: 3404-11.

Exclusion, since premature ovarian failure and/or pregnancy were not the outcome, loss of ovarian function (indicated by ongoing menses) is outcome

3

Charpentier AM, Chong AL, Gingras-Hill G, Ahmed S, Cigsar C, Gupta AA, et al. Anti-Mullerian hormone screening to assess ovarian reserve among female survivors of childhood cancer. Journal of cancer survivorship : research and practice. 2014.

Exclusion, since AMH value is outcome, association with ovarian reserve

4

Dillon KE, Sammel MD, Prewitt M, Ginsberg JP, Walker D, Mersereau JE, et al. Pretreatment antimullerian hormone levels determine rate of posttherapy ovarian reserve recovery: acute changes in ovarian reserve during and after chemotherapy. Fertility and sterility. 2013; 99: 477-83.

Exclusion, since ovarian reserve impairment is outcome, AMH level is not linked with pregnancy

5

El-Shalakany AH, Ali MS, Abdelmaksoud AA, Abd El-Ghany S, Hasan EA. Ovarian function in female survivors of childhood malignancies. Pediatric hematology and oncology. 2013; 30: 328-35.

AMH levels is outcome.

6

Krawczuk-Rybak M, Leszczynska E, Poznanska M, elazowska-Rutkowska B, Wysocka J. Anti-mullerian hormone as a sensitive marker of ovarian function in

young cancer survivors. Int J Endocrinol 2013;2013:125080.

No chemotherapy

7

Nielsen SN, Andersen AN, Schmidt KT, Rechnitzer C, Schmiegelow K, Bentzen JG, et al. A 10-year follow up of reproductive function in women treated for childhood cancer. Reproductive biomedicine online. 2013; 27: 192-200.

Outcome is ovarian function (AMH levels)

P

keywords

operator

Title (ti), abstract(ab) of tekst (tw)

1

"Neoplasms"[Mesh] or "neoplastic processes"[Mesh] or "neoplasm staging"[Mesh] or "neoplasm metastasis" [Mesh]

OR

Cancer*[TIAB] or tumor*[TIAB] or tumour*[TIAB] or carcinoma*[TIAB] or neoplasm*[TIAB] or lymphoma[TIAB] or melanoma[TIAB] or staging[TIAB] or neoplastic process*[TIAB] or non small cell[TIAB] or adenocarcinoma*[TIAB] or squamous cell[TIAB] or nsclc [TIAB] or osteosarcoma*[TIAB]or phyllodes[TIAB] or cystosarcoma*[TIAB]or fibroadenoma*[TIAB] or non small cell[TIAB] or plasmacytoma*[TIAB] or myeloma[TIAB] or multiple myeloma[TIAB] or lymphoblastoma*[TIAB] or lymphocytoma*[TIAB] or lymphosarcoma*[TIAB] or immunocytoma[TIAB] or sarcoma*[TIAB] or hodgkin*[TIAB] or nonhodgkin[TIAB] or non hodgkin*[TIAB] or oncolog*[TIAB] or malignan*[TIAB] or carcino*[TIAB] or sarcoma*[TIAB] or leukemi*[TIAB] or lymphom*[TIAB]

2

"drug therapy"[Mesh] or "drug therapy" [Subheading]

OR

Chemotherap*[TIAB]

I

Keywords, Mesh

operator

Words in title (ti), abstract (ab)

"Anti-Mullerian Hormone" [Mesh]

OR

"Anti-Mullerian Hormone" [tiab]

OR

"AMH" [tiab]

P

trefwoorden

operator

woorden in titel (ti), abstract (ab) of tekst (tw)

1

‘Neoplasm'/exp

OR

Cancer*:ab,ti or tumor*:ab,ti or tumour*:ab,ti or carcinoma*:ab,ti or neoplasm*:ab,ti or lymphoma:ab,ti or melanoma:ab,ti or staging:ab,ti or (neoplastic:ab,ti AND process*:ab,ti) or (non:ab ti AND small:ab,ti AND cell:ab,ti) or adenocarcinoma*:ab,ti or (squamous:ab,ti AND cell:ab,ti) or nsclc:ab,ti or osteosarcoma*:ab,ti or phyllodes:ab,ti or cystosarcoma*:ab ti or fibroadenoma*:ab,ti or plasmacytoma*:ab,ti or myeloma:ab ti or (multiple:ab,ti AND myeloma:ab,ti) or lymphoblastoma*:ab,ti or lymphocytoma*:ab,ti or lymphosarcoma*:ab,ti or immunocytoma:ab,ti or sarcoma*:ab,ti or hodgkin*:ab,ti or nonhodgkin:ab,ti or (non:ab,ti AND hodgkin*:ab,ti) or oncolog*:ab,ti or malignan*:ab,ti or carcino*:ab,ti or sarcoma*:ab,ti or leukemi*:ab,ti or lymphom*:ab,ti

‘adjuvant chemotherapy'/exp

OR

chemotherap*:ab,ti

I

Keywords, major heading

Operator

Words in title (ti), abstact(ab) or textword (tx)

‘Muellerian inhibiting factor'/exp

OR

‘Anti-Müllerian Hormone':ab,ti or ‘AMH': ab,ti

P

Keywords, Mesh

operator

Words in title (ti), abstract (ab) or textword (tx)

MeSH descriptor: [Neoplasms] explode all trees

OR

(Cancer* or tumor* or tumour* or carcinoma* or neoplasm* or lymphoma or melanoma or neoplastic process* or non small cell or adenocarcinoma* or squamous cell or nsclc or osteosarcoma* or phyllodes or cystosarcoma* or fibroadenoma* or non small cell or plasmacytoma* or myeloma or multiple myeloma or lymphoblastoma* or lymphocytoma* or lymphosarcoma* or immunocytoma or sarcoma* or hodgkin* or nonhodgkin or non hodgkin* or oncolog* or malignan* or carcino* or sarcoma*or leukemi* or lymphom*):ti,ab

Mesh descriptor: [Chemotherapy]

OR

Chemotherapy:ti,ab

I

Keywords, Mesh

operator

Words in title (ti), abstract (ab) or textword (tx)

MeSH descriptor: [Anti-Mullerian Hormone] explode all trees

OR

Anti-Müllerian hormone OR AMH:ti,ab

Reference

Reason exclusion

1

Bedaiwy MA, Abou-Setta AM, Desai N, Hurd W, Starks D, El-Nashar SA, et al. Gonadotropin-releasing hormone analog cotreatment for preservation of ovarian function during gonadotoxic chemotherapy: A systematic review and meta-analysis. Fertility and sterility. 2011; 95: 906-14.e4.

Sys rev, but search date Jan 2010, Chen et al is more recent.

2

Behringer K, Thielen I, Mueller H, Goergen H, Eibl AD, Rosenbrock J, et al. Fertility and gonadal function in female survivors after treatment of early unfavorable Hodgkin lymphoma (HL) within the German Hodgkin Study Group HD14 trial. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2012; 23: 1818-25.

No GnRH-analogue given

3

Blumenfeld Z. Preservation of ovarian function and minimizing premature ovarian failure during chemotherapy using gonadotropin-releasing hormone analogs. Women's health (London, England). 2011; 7: 635-40.

 Editorial

4

Chen H, Li J, Cui T, Hu L. Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy induced premature ovarian failure in premenopausal women. The Cochrane database of systematic reviews. 2011; Cd008018.

Cochrane review, include

5

Cheng YC, Takagi M, Milbourne A, Champlin RE, Ueno NT. Phase II study of gonadotropin-releasing hormone analog for ovarian function preservation in hematopoietic stem cell transplantation patients. The oncologist. 2012; 17: 233-8.

No comparison group

6

Cruz MRS, Motta E, Silva EMK, Bernardo SG, Atallah AN. Gonadotrophin-releasing hormone analogues for ovarian function preservation in women with premenopausal breast cancer undergoing adjuvant chemotherapy: A systematic review and meta-analysis. Cancer Research. 2011; 71.

abstract

7

Del Mastro L, Boni L, Michelotti A, Gamucci T, Olmeo N, Gori S, et al. Effect of the gonadotropin-releasing hormone analogue triptorelin on the occurrence of chemotherapy-induced early menopause in premenopausal women with breast cancer: a randomized trial. JAMA : the journal of the American Medical Association. 2011; 306: 269-76.

Include

8

Del Mastro L, Ceppi M, Poggio F, Bighin C, Peccatori F, Demeestere I, et al. Gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in cancer women: systematic review and meta-analysis of randomized trials. Cancer treatment reviews. 2014; 40: 675-83.

Include

9

Demeestere I, Brice P, Peccatori FA, Kentos A, Gaillard I, Zachee P, et al. Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013; 31: 903-9.

include

10

Digeni A, Symeonidis A, Georgopoulos NA. Effect of the gonadotropin-releasing hormone antagonist cetrorelix on the prevention of chemotherapy-induced ovarian damage in women with hematological malignancy. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2012; 118: 73-4.

Observational study

11

Elgindy EA, El-Haieg DO, Khorshid OM, Ismail EI, Abdelgawad M, Sallam HN, et al. Gonadatrophin suppression to prevent chemotherapy-induced ovarian damage: a randomized controlled trial. Obstetrics and gynecology. 2013; 121: 78-86.

Include

12

Gadducci A, Tana R, Sergiampietri C, Guiggi I. Fertility outcome of breast cancer and Hodgkin's lymphoma female survivors: a growing clinical challenge for gynecologists and oncologists. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2013; 29: 729-34.

Narrative review

13

Gerber B, von Minckwitz G, Stehle H, Reimer T, Felberbaum R, Maass N, et al. Effect of luteinizing hormone-releasing hormone agonist on ovarian function after modern adjuvant breast cancer chemotherapy: the GBG 37 ZORO study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2011; 29: 2334-41.

include

14

Karimi-Zarchi M, Forat-Yazdi M, Vafaeenasab MR, Nakhaie-Moghadam M, Miratashi-Yazdi A, Teimoori S, et al. Evaluation of the effect of GnRH agonist on menstrual reverse in breast cancer cases treated with cyclophosphamide. European journal of gynaecological oncology. 2014; 35: 59-61.

Include

15

Meirow D, Raanani H, Maman E, Paluch-Shimon S, Shapira M, Cohen Y, et al. Tamoxifen co-administration during controlled ovarian hyperstimulation for in vitro fertilization in breast cancer patients increases the safety of fertility-preservation treatment strategies. Fertility and sterility. 2014.

Observational study

16

Munster PN, Moore AP, Ismail-Khan R, Cox CE, Lacevic M, Gross-King M, et al. Randomized trial using gonadotropin-releasing hormone agonist triptorelin for the preservation of ovarian function during (neo)adjuvant chemotherapy for breast cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2012; 30: 533-8.

include

17

Nawroth F. GnRH analogs for fertility preservation - Let's not jump to conclusions. Breast Care. 2012; 7: 501-03.

editorial

18

Song G, Gao H, Yuan Z. Effect of leuprolide acetate on ovarian function after cyclophosphamide-doxorubicin-based chemotherapy in premenopausal patients with breast cancer: results from a phase II randomized trial. Medical oncology (Northwood, London, England). 2013; 30: 667.

include

19

Sun X, Dongol S, Jiang J, Kong B. Protection of ovarian function by GnRH agonists during chemotherapy: a meta-analysis. International journal of oncology. 2014; 44: 1335-40.

Include

20

Turner NH, Partridge A, Sanna G, Di Leo A, Biganzoli L. Utility of gonadotropin-releasing hormone agonists for fertility preservation in young breast cancer patients: the benefit remains uncertain. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2013; 24: 2224-35.

Narrative review

21

Vitek W, Hoeger K, Han Y, Messing S, Shayne M, Fung C. Systematic review and meta-analysis of GNRH agonist for preservation of ovarian function in women with hormone receptor negative breast cancer after chemotherapy. Fertility and sterility. 2013; 100: S117.

abstract

22

Vitek WS, Shayne M, Hoeger K, Han Y, Messing S, Fung C. Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis. Fertility and sterility. 2014.

Include

23

Wang C, Chen M, Fu F, Huang M. Gonadotropin-Releasing Hormone Analog Cotreatment for the Preservation of Ovarian Function during Gonadotoxic Chemotherapy for Breast Cancer: A Meta-Analysis. PloS one. 2013; 8: e66360.

Include

24

Whitehead J, Toledo MG, Stern CJ. A pilot study to assess the use of the gonadotrophin antagonist cetrorelix in preserving ovarian function during chemotherapy. The Australian & New Zealand journal of obstetrics & gynaecology. 2011; 51: 452-4.

No comparison group

25

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. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2013; 24: 133-8.

Observational study

26

Yang B, Shi W, Yang J, Liu H, Zhao H, Li X, et al. Concurrent treatment with gonadotropin-releasing hormone agonists for chemotherapy-induced ovarian damage in premenopausal women with breast cancer: a meta-analysis of randomized controlled trials. Breast (Edinburgh, Scotland). 2013; 22: 150-7.

include

27

Zhang Y, Xiao Z, Wang Y, Luo S, Li, X, Li S. Gonadotropin-Releasing Hormone for Preservation of Ovarian Function during Chemotherapy in Lymphoma Patients of Reproductive Age: A Summary Based on 434 Patients. PLoS ONE 8(11): e80444. doi:10.1371

Exclude, meta-analysis is mix of RCT's and case-control studies

June 2015 update

28

Bansal A, Patel FD, Rai B, Dhanireddy B, Sharma SC. Gonadotrophin releasing hormone analogues for ovarian function preservation in young females undergoing chemotherapy. Asian Pacific journal of cancer prevention : APJCP 2014;15(5):2185-90.

Excluded because meta-analysis mixes RCT's and case series.

29

Blumenfeld Z, Katz G, Evron A. ‘An ounce of prevention is worth a pound of cure': the case for and against GnRH-agonist for fertility preservation. Annals of Oncology 2014;25:1719-28

Excluded because it is no systematic review, but a narrative review.

30

Blumenfeld Z, Evron A. Preserving fertility when choosing chemotherapy regimens-the role of gonadotropin-releasing hormone agonists. Expert Opin. Pharmacother.2015;16(7):1009-20

Excluded because meta-analysis mixes retrospective and RCT's.

31

Blumenfeld Z, Zur H, Mischari O, Schultz N, Balbir-Gurman A. Cotreatment with GNRH-agonist before and in parallel to gonadotoxic chemotherapy significantly preserves fertility and increases pregnancy rate in addition to cyclic ovarian function. Journal: Conference Abstract

Excluded, only abstract / poster.

32

Chabbert-Buffet N, Esber N, Bouchard P. Fibroid growth and medical options for treatment. Fertil Steril. 2014;102(3):630-9.

Excluded, because it is no fertility preservation.

33

Del Mastro L, Levaggi A, Poggio F, Giraudi S, Bighin C, D'Alonzo A. Role of temporary ovarian suppression obtained with gnrh analog in reducing premature ovarian failure (POF) induced by chemotherapy in premenopausal cancer patients: A meta-analysis of randomized studies. Annals of Oncology 2012:501.

Excluded, only abstract / poster.

34

Elgindy EA, ,Mostafa, MI, Sibai H, AbdelGhany AM. Adjuvant Gonadotropin-Releasing Hormone Analogues for the Prevention of Chemotherapy Induced Gonadal Toxicity: A Systematic Review and Meta-Analysis. Fertility and Sterility 2014;102(3):e127.

Excluded, only abstract / poster.

35

Gharwan H, Wilkerson J, Fojo AT. GNRH-agonist co-treatment during chemotherapy for the preservation of ovarian function: A meta-analysis. Fertility and Sterility 2014;102(3):e159.

Excluded, meta-analysis included as well case series + reference is only abstract / poster

36

Grimes A, Robinson R, Assanasen C, Knudtson J. Hormonal suppression experience for ovarian preservation during chemotherapy. Pediatric Blood and Cancer 2014;61:s19.

Excluded, only abstract / poster.

37

Karimi-Zarchi M, Forat-Yazdi M, Vafaeenasab MR, Nakhaie-Moghadam M, Miratashi-Yazdi A, Teimoori S. Evaluation of the effect of GnRH agonist on menstrual reverse in breast cancer cases treated with cyclophosphamide. European journal of gynaecological oncology 2014;35(1):59-61.

Include, however overlap with previous search (was already included).

38

Lambertini M, Boni L, Michelotti A, Gamucci T, Olmeo N, Gori S, et al. Long-term outcome results of the phase III PROMISE-GIM6 study evaluating the role of LHRH analog (LHRHa) during chemotherapy (CT) as a strategy to reduce ovarian failure in early breast cancer (BC) patients. Journal of clinical oncology 2014;32(26).

Excluded, only abstract / poster.

39

Moore HCF, Unger JM, Phillips KA, Boyle FM, Hitre E, Porter DJ, et al. Phase III trial (Prevention of Early Menopause Study [POEMS]-SWOG S0230) of LHRH analog during chemotherapy (CT) to reduce ovarian failure in early-stage, hormone receptor-negative breast cancer: An international Intergroup trial of SWOG, IBCSG, ECOG, and CALGB (Alliance). Journal of clinical oncology 2014;32(15).

Excluded, only abstract / poster.

40

Park CY, Jung SY, Lee KB, Yang SH. The feasibility and efficacy of gonadotropin-releasing hormone agonists for prevention of chemotherapy induced ovarian failure in patient with gynecological malignancies. Obstet Gynecol Sci 2014:57(6):478-83.

Excluded, retrospective study.

41

Vitek WS, Shayne M, Hoeger K, Han Y, Messing S, Fung C. Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: A systematic review and meta-analysis. Fertility and Sterility 2014;102(3):808-15.

Include, however overlap with previous search (was already included).

1

Chen H, Li J, Cui T, Hu L. Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy induced premature ovarian failure in premenopausal women. The Cochrane database of systematic reviews. 2011; Cd008018.

Include, however this RCT is part of Sun et al, 2014 which is the most recent systematic review

2

Del Mastro L, Boni L, Michelotti A, Gamucci T, Olmeo N, Gori S, et al. Effect of the gonadotropin-releasing hormone analogue triptorelin on the occurrence of chemotherapy-induced early menopause in premenopausal women with breast cancer: a randomized trial. JAMA : the journal of the American Medical Association. 2011; 306: 269-76.

Include, however Sun et al, 2014 is the most recent systematic review

3

Del Mastro L, Ceppi M, Poggio F, Bighin C, Peccatori F, Demeestere I, et al. Gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in cancer women: systematic review and meta-analysis of randomized trials. Cancer treatment reviews. 2014; 40: 675-83.

Include

4

Demeestere I, Brice P, Peccatori FA, Kentos A, Gaillard I, Zachee P, et al. Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013; 31: 903-9.

 Include, however Sun et al, 2014 is the most recent systematic review

5

Elgindy EA, El-Haieg DO, Khorshid OM, Ismail EI, Abdelgawad M, Sallam HN, et al. Gonadatrophin suppression to prevent chemotherapy-induced ovarian damage: a randomized controlled trial. Obstetrics and gynecology. 2013; 121: 78-86.

 Include, however Sun et al, 2014 is the most recent systematic review

6

Gerber B, von Minckwitz G, Stehle H, Reimer T, Felberbaum R, Maass N, et al. Effect of luteinizing hormone-releasing hormone agonist on ovarian function after modern adjuvant breast cancer chemotherapy: the GBG 37 ZORO study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2011; 29: 2334-41.

 Include, however Sun et al, 2014 is the most recent systematic review

7

Karimi-Zarchi M, Forat-Yazdi M, Vafaeenasab MR, Nakhaie-Moghadam M, Miratashi-Yazdi A, Teimoori S, et al. Evaluation of the effect of GnRH agonist on menstrual reverse in breast cancer cases treated with cyclophosphamide. European journal of gynaecological oncology. 2014; 35: 59-61.

Include

8

Munster PN, Moore AP, Ismail-Khan R, Cox CE, Lacevic M, Gross-King M, et al. Randomized trial using gonadotropin-releasing hormone agonist triptorelin for the preservation of ovarian function during (neo)adjuvant chemotherapy for breast cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2012; 30: 533-8.

Include, however Sun et al, 2014 is the most recent systematic review

9

Song G, Gao H, Yuan Z. Effect of leuprolide acetate on ovarian function after cyclophosphamide-doxorubicin-based chemotherapy in premenopausal patients with breast cancer: results from a phase II randomized trial. Medical oncology (Northwood, London, England). 2013; 30: 667.

Include,

10

Sun X, Dongol S, Jiang J, Kong B. Protection of ovarian function by GnRH agonists during chemotherapy: a meta-analysis. International journal of oncology. 2014; 44: 1335-40.

Include

11

Vitek WS, Shayne M, Hoeger K, Han Y, Messing S, Fung C. Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis. Fertility and sterility. 2014.

Include, however Sun et al, 2014 is the most recent systematic review

12

Wang C, Chen M, Fu F, Huang M. Gonadotropin-Releasing Hormone Analog Cotreatment for the Preservation of Ovarian Function during Gonadotoxic Chemotherapy for Breast Cancer: A Meta-Analysis. PloS one. 2013; 8: e66360.

Include, however Sun et al, 2014 is the most recent systematic review

13

Yang B, Shi W, Yang J, Liu H, Zhao H, Li X, et al. Concurrent treatment with gonadotropin-releasing hormone agonists for chemotherapy-induced ovarian damage in premenopausal women with breast cancer: a meta-analysis of randomized controlled trials. Breast (Edinburgh, Scotland). 2013; 22: 150-7.

Include, however Sun et al, 2014 is the most recent systematic review

Included in June 2015 update

14

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

Include

#

Reference

In- or Exclusion and reason

1

Bastings L, Baysal O, Beerendonk CC, IntHout J, Traas MA, Verhaak CM, et al. Deciding about fertility preservation after specialist counselling. Human reproduction (Oxford, England). 2014; 29: 1721-9.

Exclusion, no comparison group

2

Browne H, Nurudeen S, Armstrong A, Decherney A. Ethical and psychological considerations in fertility preservation counseling. Cancer journal (Sudbury, Mass). 2008; 14: 340-2.

Editiorial

3

Coleman SL, Grothey A. Should oncologists routinely discuss fertility preservation with cancer patients of childbearing age? Mayo Clinic proceedings Mayo Clinic. 2011; 86: 6-7.

Editorial

4

Gardino SL, Emanuel LL. Choosing life when facing death: understanding fertility preservation decision-making for cancer patients. Cancer treatment and research. 2010; 156: 447-58.

Narrative review

5

Garvelink MM, Ter Kuile MM, Bakker RM, Geense WJ, Jenninga E, Louwe LA, et al. Women's experiences with information provision and deciding about fertility preservation in the Netherlands: 'satisfaction in general, but unmet needs'. Health expectations : an international journal of public participation in health care and health policy. 2013.

No comparison group

6

Garvelink MM, Ter Kuile MM, Louwe LA, Hilders CG, Stiggelbout AM. A Delphi consensus study among patients and clinicians in the Netherlands on the procedure of informing young breast cancer patients about Fertility Preservation. Acta oncologica (Stockholm, Sweden). 2012; 51: 1062-9.

A qualitative study

7

Kim J, Deal AM, Balthazar U, Kondapalli LA, Gracia C, Mersereau JE. Fertility preservation consultation for women with cancer: are we helping patients make high-quality decisions? Reproductive biomedicine online. 2013; 27: 96-103.

No cancer patients

8

Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013; 31: 2500-10.

Not specific on FP cousenling

9

Martinez F, Devesa M, Coroleu B, Tur R, Gonzalez C, Boada M, et al. Cancer and fertility preservation: Barcelona consensus meeting. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2013; 29: 285-91.

Overview of FP procedures

10

Mersereau JE, Goodman LR, Deal AM, Gorman JR, Whitcomb BW, Su HI. To preserve or not to preserve: how difficult is the decision about fertility preservation? Cancer. 2013; 119: 4044-50.

Study on FP counselling yes/no,but no stratification on FP provider.

11

Nawroth F. Fertility preservation consultation for women with cancer: are we helping patients make high quality decisions? Reproductive biomedicine online. 2013; 27: 29-30.

Commentary

12

Niemasik EE, Letourneau J, Dohan D, Katz A, Melisko M, Rugo H, et al. Patient perceptions of reproductive health counseling at the time of cancer diagnosis: a qualitative study of female California cancer survivors. Journal of cancer survivorship : research and practice. 2012; 6: 324-32.

Study on FP counselling yes/no,but no stratification on FP provider.

13

Peate M, Meiser B, Friedlander M, Zorbas H, Rovelli S, Sansom-Daly U, et al. It's now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2011; 29: 1670-7.

Knowledge of FP, no comparison

14

Peate M, Meiser B, Hickey M, Friedlander M. The fertility-related concerns, needs and preferences of younger women with breast cancer: a systematic review. Breast cancer research and treatment. 2009; 116: 215-23.

Narrative review

15

Peddie VL, Porter MA, Barbour R, Culligan D, MacDonald G, King D, et al. Factors affecting decision making about fertility preservation after cancer diagnosis: a qualitative study. BJOG : an international journal of obstetrics and gynaecology. 2012; 119: 1049-57.

Qualitative study

16

Quinn GP, Murphy D, Knapp C, Stearsman DK, Bradley-Klug KL, Sawczyn K, et al. Who decides? Decision making and fertility preservation in teens with cancer: a review of the literature. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2011; 49: 337-46.

Narrative review

17

Thewes B, Meiser B, Rickard J, Friedlander M. The fertility and menopause-related information needs of younger women" with a diagnosis of breast cancer: A qualitative study. "Psycho-oncology. 2003; 12: 500-11."

Qualitative study

18

Thewes B, Meiser B, Taylor A, Phillips KA, Pendlebury S, Capp A, et al. Fertility- and menopause-related information" needs of younger women with a diagnosis of early breast cancer. Journal of Clinical Oncology. "2005;" 23:00 5155-65.

Study on FP information needs

8

Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, et al. Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer. 2012; 118: 1710-7.

Include

14

Peate M, Meiser B, Cheah BC, Saunders C, Butow P, Thewes B, et al. Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. British journal of cancer. 2012; 106: 1053-61.

Include

P

keywords

operator

Title (ti), abstract(ab) or textword (Tx)

1

"Neoplasms"[Mesh] or "neoplastic processes"[Mesh] or "neoplasm staging"[Mesh] or "neoplasm metastasis" [Mesh]

OR

Cancer*[TIAB] or tumor*[TIAB] or tumour*[TIAB] or carcinoma*[TIAB] or neoplasm*[TIAB] or lymphoma[TIAB] or melanoma[TIAB] or staging[TIAB] or neoplastic process*[TIAB] or non small cell[TIAB] or adenocarcinoma*[TIAB] or squamous cell[TIAB] or nsclc [TIAB] or osteosarcoma*[TIAB]or phyllodes[TIAB] or cystosarcoma*[TIAB]or fibroadenoma*[TIAB] or non small cell[TIAB] or plasmacytoma*[TIAB] or myeloma[TIAB] or multiple myeloma[TIAB] or lymphoblastoma*[TIAB] or lymphocytoma*[TIAB] or lymphosarcoma*[TIAB] or immunocytoma[TIAB] or sarcoma*[TIAB] or hodgkin*[TIAB] or nonhodgkin[TIAB] or non hodgkin*[TIAB] or oncolog*[TIAB] or malignan*[TIAB] or carcino*[TIAB] or sarcoma*[TIAB] or leukemi*[TIAB] or lymphom*[TIAB]

2

"Fertility preservation"[Mesh]

OR

Fertility preservation[TIAB]

I

Keywords, Mesh

operator

Words in title (ti), abstract (ab)

"Decision Making"[Mesh]

OR

decision making [tiab]

"Decision Support Techniques"[Mesh]

OR

decision support [tiab]

"Counseling"[Mesh]

OR

counseling [tiab]

"Patient Education as Topic"[Mesh]

"Patient Participation"[Mesh]

"Conflict (Psychology)"[Mesh]

"Referral and Consultation"[Mesh]

P

Keywords(major heading)

operator

Words in title (ti), abstract(ab) or textword(TX)

(MH "Neoplasms+")

OR

TX Cancer* or TX tumor* or TX tumour* or TX carcinoma* or TX neoplasm* or TX lymphoma or TX melanoma or TX neoplastic process* or non small cell or adenocarcinoma* or squamous cell or nsclc or TX osteosarcoma* or TX phyllodes or TX cystosarcoma* or TX fibroadenoma* or TX non small cell or TX plasmacytoma* or TX myeloma or TX multiple myeloma or TX lymphoblastoma* or TX lymphocytoma* or TX lymphosarcoma* or TX immunocytoma or TX sarcoma* or TX hodgkin* or TX nonhodgkin or TX non hodgkin* or TX oncolog* or TX malignan* or TX carcino* or TX sarcoma* or TX leukemi* or TX lymphom*

MH Fertility

OR

TX fertility

I

Keywords, major heading

Operator

Words in title (ti), abstact(ab) or textword (tx)

MH Decision making

OR

TX Decision making or TX decision support techniques or TX decision aid

MH Counselling

OR

TX counselling

P

Keywords, Mesh

operator

Words in title (ti), abstract (ab) or textword (tx)

MeSH descriptor: [Neoplasms] explode all trees

OR

(Cancer* or tumor* or tumour* or carcinoma* or neoplasm* or lymphoma or melanoma or neoplastic process* or non small cell or adenocarcinoma* or squamous cell or nsclc or osteosarcoma* or phyllodes or cystosarcoma* or fibroadenoma* or non small cell or plasmacytoma* or myeloma or multiple myeloma or lymphoblastoma* or lymphocytoma* or lymphosarcoma* or immunocytoma or sarcoma* or hodgkin* or nonhodgkin or non hodgkin* or oncolog* or malignan* or carcino* or sarcoma*or leukemi* or lymphom*):ti,ab

MeSH descriptor: [Fertility Preservation] explode all trees

OR

(fertility and preservation):ti,ab

MeSH descriptor: [Fertility] explode all trees

OR

Fertility:ti,ab

I

Keywords, Mesh

operator

Words in title (ti), abstract (ab) or textword (tx)

MeSH descriptor: [Decision Making] explode all trees

or

(decision and making):ti,ab or counseling:ti,ab

MeSH descriptor: [Decision Support Techniques] explode all trees

OR

(Decision and aid):ti,ab or (decision and support and techniques):ti,ab

P

Keywords, Mesh

operator

Words in title (ti), abstract (ab) or textword (tx)

1

exp Neoplasms/

OR

cancer$.ti,ab. or tumor$.ti,ab. or tumour$.ti,ab. or carcinoma$.ti,ab. or neoplasm$.ti,ab. or lymphoma.ti,ab. or melanoma.ti,ab. or staging.ti,ab. or neoplastic process$.ti,ab. or non small cell.ti,ab. or (non adj small adj cell).ti,ab. or (non adj2 small adj2 cell).ti,ab. or (nonsmall adj2 cell).ti,ab. or adenocarcinoma$.ti,ab. or squamous cell.ti,ab. or nsclc.ti,ab. or osteosarcoma$.ti,ab. or phyllodes.ti,ab. or cystosarcoma$.ti,ab. or fibroadenoma$.ti,ab. or plasmacytoma$.ti,ab. or myeloma.ti,ab. or lymphoblastoma$.ti,ab. or lymphocytoma$.ti,ab. or lymphosarcoma$.ti,ab. or immunocytoma.ti,ab. or sarcoma$.ti,ab. or hodgkin$.ti,ab. or (nonhodgkin$ or non hodgkin$).ti,ab. or oncolog$.ti,ab or malignan$.ti,ab or carcino$.ti,ab or sarcoma$.ti,ab or leukemi$.ti,ab or lymphom$.ti,ab

2

exp Fertility/

OR

Fertility.mp

I

Keywords, Mesh

operator

Words in title (ti), abstract (ab) or textword (tx)

3

exp Decision Making/

OR

Decision making.mp or decision support techniques.mp. or decision aid.mp.

4

exp counselling/

or

Counselling.mp

I Study ID

 II Method

III Patient characteristics

IV Intervention(s)

V Results patient relevant outcomes

VII Critical appraisal of review quality

[Sun 2014]

• Meta analysis All cancer
• National Natural Science Foundation, science and technology developing planning (of Jinan)
• Search date: Nov 2013
• Searched databases: Medline, Cochrane Library, Embase CNKI, Warfang
• Included study designs: RCT's
• Number of included studies: 8

• Eligibility criteria: Premenopausal females <46 years of age undergoing gonadotoxic chemotherapy, the control group does not receive GnRHa, clear definition to evaluate ovarian function
• A priori patient characteristics: N=621 women, age range 12-46

GnRHa (triptoreplin, goserelin, buserelin, dipherelin) Subcutaneous, intramuscular, or intranasal during chemotherapy (n=321)

vs.

No GnRHa during chemotherapy (n=300)

• Resumed menstruation (critical; 8 studies):

N=248/321 vs. 185/300

Risk ratio 1.25 (95%CI 0.99-1.58)

• Premature Ovarian Failure (POF; critical) (8 studies*):

N=31/321 vs. 80/300

Risk ratio 0.45 (95% CI 0.22-0.92)

• Pregnancies (critical; 5 studies):

6/253 vs. 6/231

Risk ratio 0.93 (95% CI 0.33-2.61)

* definition varies : no menses within 12 months and post-menopausal FSH and E2, amenorrhea, no regular menses, early cessation of menstruation, FSH≤ 20 mlu/ml.

• Low risk of bias for systematic review
• No blinding possible

[Vitek 2014]

• Meta-analysis: breast cancer
• No CoI
• University of Rochester award number UL1 TR000042 from the National Center for Advancing Translational Sciences of the National Institutes of Health.
• Search date: March 2014
• Searched databases: PubMed, Scopus, Cochrane Trials Register, National Research Register.
• Included study design: RCT's
• Number of included studies: 5 of which 4 were included in met-analysis

• Eligibility criteria:

Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen

(no stratification for hormone receptor status)

• A Priori patient characteristics: premenopausal women, age range 18-45.

GnRHa with chemotherapy (n=131)

Vs.

Chemotherapy (n=121)

• Resumed menstruation at 12-24 months (critical; 4 studies):

N=98/131 vs. 87/121

Risk ratio 1.47 (95% CI 0.60-3.62)

• Premature Ovarian Failure (POF; critical):

Not reported

• Pregnancies (critical):

Not reported

• High risk of bias, since quality of studies included was not assessed.

I Study ID

 II Method

III Patient characteristics

IV Intervention(s)

V Results

VII Critical appraisal of study quality

• [Waxman 1987]

• RCT
• No CoI
• Did not mention single or multiple centre, England
• N=17
• Follow up 3 years after completing treatment

• Eligibility criteria, women between 17 and 46 years old with Hodgkin's disease
• Patient characteristics:

Mean age: 28.5 (17-34) vs. 25.9 (17-46); Mean follow up 2.3 (1.8-2.5) vs. 2.0 (1-2.5)

GnRH: buserelin + chemotherapy (n=8)

vs.

Chemotherapy (n=9)

• Resumed menses (critical):

4/8 vs. 6/9

Risk Ratio 0.75 (95% CI 0.33-1.72) (from Sun et al)

• Premature Ovarian Failure (POF; amenorrhea) (critical):

4/8 vs. 3/9

Risk ratio 1.50 (95% CI 0.47-4.76) (from Sun et al)

• Pregnancies (crititcal):

0/8 vs. 1/10

Risk ratio 0.41 (95% 0.02-8.84)

• No blinding possible, no clear allocation concealment,
• Low number of events

• [Guiseppe 2007(4)

• RCT
• No CoI reported
• Single center, Italy
• N=29
• Follow up every 6 months after cessation of chemotherapy

• Eligibility criteria:

Cancer survivors previously affected Hodgkin Disease treated with the same standardized chemotherapeutic schedule.

• Patient characteristics: mean age at observation: 26.7 ± 5.22 vs. 30.26± 8.71 (p= NS)

GnRHa (triptorellin monthly 3.25 mg or 11.25 depot every 3 months) +chemotherapy (n=14)

Vs.

Chemotherapy (n=15)

• Resumed menses (regular cycles); critical:

14/14 vs. 8/15

Risk Ratio 1.82 (95% CI 1.14-2.91) (from Cochrane meta-analysis(5))

• Premature Ovarian Failure (POF; no menses within 12 months)(critical):

0/14 vs. 7/15

Risk ratio 0.07 (95% CI 0.00-1.14) (from Cochrane meta-analysis(5))

• Pregnancies (critical):

0/14 vs. 2/15

Risk ratio 0.21(95% CI 0.01-4.09) (from Cochrane meta-analysis (5))

• Unclear allocation concealment, no blinding possible, unclear risk of incomplete outcome data
• Low number of events

• [Behringer 2010]

• RC T
• Funding Deutsche Krebshilfe, Kompetenznetz; Maligne Lymphome.
• No CoI
• N=19
• Follow up 18 months after therapy

• Eligibility criteria: Hodgkin Lymphoma at first diagnosis, history of a spontaneous menstrual cycle, no primary ovarian failure and follicle-stimulating hormone levels≤ 30U/l at baseline, age between 18 and 40 years
• Patient characteristics: mean age: 25.3 vs. 25.9

BEACOPP+ goserelin (n=10)

Vs.

BEACOPP+ oral contraceptive (Levonorgestrel+ethinylestradiol) (n=9)

• Resumed menses:

7/10 vs. 3/9

• Premature Ovarian Failure (POF):

Not reported

• Pregnancies (critical):

0 pregnancies

• Study prematurely closed after interim analysis

high risk of bias, no blinding possible, no clear allocation concealment, low number of events

• [Demeestere 2013]

• RCT
• Fonds National de al Recherche Scientifique and unconditional grant from the Ipsen Pharmaceutical Group.
• 15 oncological centers in France Belgium an Italy
• N=129
• July 2002-April 2010

• Eligibility criteria: premenopausal women between 18 and 45 years old and being treated for Hodgkin and no-Hodgkin lymphoma with alkylating agents
• A priori patient characteristics: mean age 25.57 vs. 27.27
• Hodgkin lymphoma 24(53.3%) vs. 26 (66.7%), non-hodgkin lymphoma 21 (46.7%) vs. 13 (33.3%)

GnRHa triptorelin plus norethisterone in combination with chemotherapy (n=65)

vs.

Norethisterone alone in combination with chemotherapy (n=64)

• Resumed menses (critical)

Not reported

• Premature ovarian Failure (POF; FSH ≥ 40 IU/L ) after 1 year of follow up(critical):

GnRHa group: 20%

Control group: 19% p=1.00

• Pregnancies (critical)

N=2 in the GnRHa group during the follow up period

• High risk of bias, blinding not possible high drop out rate: n=20/65 (30.7%) in GnRHa group, n=25/64 (39%) in control group.

I Study ID

 II Method

III Patient characteristics

IV Intervention(s)

V Results

VII Critical appraisal of study quality

• [Badawy 2009]

• RCT
• No CoI reported
• Single center, Mansura, Egypt
• N=80
• Follow up 8 months after therapy

• Eligibility criteria:

Unilateral adenocarcinoma of the breast and no metastasis and aged between 18 and 40. (no information on hormore receptor status)

Patient characteristics: mean age 30 ± 3.51 vs. 29.2 ± 2.93 Parity 1.9± 0.32 vs. 1.6 ± 0.43 (p=0.04)

Serum FSH (mIU/mL) 4.3± 1.11 vs. 5.7± 1.3 (p=0.04)

Serum E₂ (pg/mL) 306±21.22 vs. 344± 25.67 (p=0.03)

GnRHa + chemotherapy (n=39)

Vs.

Chemotherapy (n=39)

• Resumed menses (critical) :

35/39 vs. 13/39

Risk ratio 2.69 (95% CI 1.71-4.25)

• Premature Ovarian Failure (POF; early cessation of menstruation, ovulation and increased serum FSH level)(critical):

4/39 (11.4%) vs. 21/39 (66.6%) p<0.001

• Pregnancies (critical):

Not reported

• Moderate risk of bias, no blinding possible, low number of events.

• [Song 2013]

• RCT
• No CoI
• Single center
• N=183
• Feb 2010 -March 2012

• Eligibility criteria: premenopausal patients between 18 and 45 years with proven histological stage I-III breast cancer. No history of prior chemotherapy or hormone therapy, no distant metastases or localized cancer relapse. No stratification on hormone receptor status.
• A priori characteristics: Mean age 42.1 vs. 40.3
• Group comparability: tumor grade G1 12.4% vs. 4.3%, G2 33.7% vs. 50.0%, G3 53.9% vs. 45.7%

Chemotherapy +leuprolide acetate (n=89)

vs.

Chemotherapy alone (n=94)

• Resumed menses (critical)

N=53/89 vs. n=39/94 (0.01<P<0.05)

Median time to resumption was 9.2 months in CT+ leuprolide acetate group

Median time to resumption was not reached in CT alone group

• Premature ovarian Failure (POF;critical))

Not reported

• Pregnancies (critical):

Not reported

• High risk of bias since allocation concealment is not clear, blinding not possible, high loss to follow up > 10%, low number of events

• [Karimi-Zarchi 2014]

• RCT
• CoI not reported
• One hospital in Iran
• N=42
• 2010-2011

• Eligibility criteria: Negative ER/PR, primary stage of breast cancer, candidate for Cyclophosphamide Adriamycin, taxoter

A priori characteristics: mean age of cases was 37±5 years (range 25-45)

No data on group comparability

Chemotherapy (cyclophosphamide, Adriamycin, taxoter) + diphereline (n=21)

vs.

Chemotherapy alone (n=21)

• Resumed menses (3 to 6 months) (critical)

N= 19/21 (90.5%) vs. N=7/21 (33.3%) p<0.001

• Premature Ovarian Failure (POF; critical)

Not reported

• Pregnancies (critical):

Not reported

• High risk of bias, unclear allocation concealment, no blinding, low number of events

• [Moore 2015]

• RCT
• CoI reported for four authors.
• Four centres
• N=257
• 2004/2011

• Eligibility criteria: Premenopausal women 18 to 49 years of age.
• Operable stage I to IIIA estrogen receptor (ER)-negative and progesterone-receptor (PR)-negative breast cancer
• A priori characteristics: median age of patients was:37.7 (range: 25.1-49.9)
• Stage of cancer of intervention vs. control: I: 22% vs. 28%, II: 52% vs. 46%, IIIA: 24% vs. 26%.

Chemotherapy plus Goserelin

(N = 105)

Vs.

Chemotherapy Alone

(N = 113)

• Resumed menses:

Not reported

• Ovarian failure (composite of menstrual status and FSH levels)
• o N=5/66 vs. 15/69 (OR:0.30, 95%-CI:0.09 - 0.97).
• Pregnancies
• o N=22/105 vs. 12/113 (OR:2.45, 95%-CI:1.09 - 5.51).

• High risk of bias due to unclear randomisation methods, unclear allocation concealment, no blinding, and high number of patients lost-to-follow up.
• In addition, difficult interpretation of results since the main outcomes are reported in composite outcomes (ovarian failure and ovarian dysfunction).

Quality assessment

No of patients

Effect

Quality

Importance

No of studies

Design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

Chemotherapy and GnRHa

Chemotherapy

Relative (95% CI)

Absolute

All cancer

Resumed menses- All cancer Sys Rev

8 [Sun 2014]

randomised trials

serious¹

serious²

no serious indirectness

serious³

none

248/321 (77.3%)

185/300 (61.7%)

RR 1.25 (0.99 to 1.58)

154 more per 1000 (6 fewer to 358 more)-

ÅOOO VERY LOW

CRITICAL

Premature Ovarian Failure -All cancer Sys Rev

8 [Sun 2014]

randomised trials

serious^1,4

serious⁵

no serious indirectness

serious³

none

31/321 (9.7%)

80/300 (26.7%)

RR 0.45 (0.22 to 0.92)

147 fewer per 1000 (from 21 fewer to 208 fewer)-

ÅOOO VERY LOW

CRITICAL

Pregnancies- All cancer Sys Rev

5 [Sun 2014]

randomised trials

serious¹

very serious⁵

no serious indirectness

serious³

none

6/253 (2.4%)

6/231 (2.6%)

RR 0.93 (0.33 to 2.61)

2 fewer per 1000 (from 17 fewer to 42 more)

ÅOOO VERY LOW

CRITICAL

Breast cancer

Resumed menses- Breast cancer Sys Rev

4 [Vitek 2014]

randomised trials

serious¹

no serious inconsistency

no serious indirectness

serious³

none

105/138

(76.1%)

93/127

(73.2%)

RR=1.47 (95% CI 0.60-3.62)

344 more per 1000 (from 293 fewer to 1000 more)

ÅÅOO LOW

CRITICAL

Resumed menses- Breast cancer RCT

3 [Badawy 2009,Song 2013, Karimi-Zarchi 2014]

randomised trials

very serious^1,4

no serious inconsistency

no serious indirectness

serious³

none

Study 1 : 35/39

Study 2: 53/89

Study 3: 19/21

Study 1: 13/39

Study 2: 39/94

Study3: 7/21

1:RR=2.69 (95% CI 1.71-4.25)

2:p<0.001

3:p<0.05

ÅOOO VERY LOW

CRITICAL

Premature Ovarian Failure- Breast Cancer Sys Rev

0

No evidence available

none

-

-

-

-

CRITICAL

-

Premature Ovarian Failure- Breast cancer RCT

2: [Badawy 2009, Moore 2015]

randomised trials

Very serious^1,4,6,7

no serious inconsistency

serious indirectness⁸

serious³

none

Study 1: 4/39 (10.3%)

Study 2: 5/66

Study 1: 21/39 (53.8%)

Study 2: 15/69

RR=0.19 (95% 0.07-0.50)

OR=0.29 (95%-CI: 0.10-0.86)

ÅOOO VERY LOW

CRITICAL

Pregnancies- Breast cancer- Sys Rev

0

No evidence available

CRITICAL

Pregnancies-Breast Cancer-RCT

1: [Moore 2015]

Randomised trials

Very serious^{1,4,6, 7}

no serious inconsistency

no serious indirectness

serious³

None

22/105

12/113

OR:0.44 (95%-CI:0.21-0.95)

ÅOOO VERY LOW

CRITICAL

Lymphoma

Resumed menses-Lymphoma -RCT

3: [Waxman 1987, Guiseppe 2007, Behringer 2010]

randomised trials

serious^1,4

no serious inconsistency

no serious indirectness

serious³

None

Study1: 4/8

Study 2: 14/14

Study 3: 7/10

Study1: 6/9

Study 2: 8/15

Study 3: 3/9

1: RR=0.75 (95% CI 0.33-1.72)

2: 1.82 (95% CI 1.14-2.91)

3: no p value reported

ÅÅOO LOW

CRITICAL

Premature Ovarian Failure-Lymphoma-RCT

3: [Waxman 1987, Guiseppe 2007, Demeestere 2013]

randomised trials

serious^1,4

no serious inconsistency

no serious indirectness

serious³

none

Study 1: 4/8

Study 2: 0/14

Study 3: 20%

Study 1: 3/9

Study 2: 7/15

Study 3: 19%

1: RR=1.50 (95% 0.47-4.76)

2: RR=0.07 (95% CI 0.00-1.14)

3: p=1.00

ÅÅOO LOW

CRITICAL

Pregnancies- Lyphoma- RCT

3: [Waxman 1987, Guiseppe 2007, Demeestere 2013]

randomised trials

very serious^1,6

no serious inconsistency

no serious indirectness

serious³

none

Study 1: 0/8

Study 2: 0/14

Study 3: 2/65

Study 1: 1/10

Study 2: 2/15

Study 3: 0/64

1: RR=0.41 (95% CI 0.02-8.84)

2: RR=0.21 (0.01-4.09

3: no p value reported

ÅOOO VERY LOW

CRITICAL

1.         Sun X, Dongol S, Jiang J, Kong B. Protection of ovarian function by GnRH agonists during chemotherapy: a meta-analysis. International journal of oncology. 2014;44(4):1335-40.

2.         Vitek WS, Shayne M, Hoeger K, Han Y, Messing S, Fung C. Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis. Fertility and sterility. 2014.

3.         Waxman JH, Ahmed R, Smith D, Wrigley PF, Gregory W, Shalet S, et al. Failure to preserve fertility in patients with Hodgkin's disease. Cancer chemotherapy and pharmacology. 1987;19(2):159-62.

4.         Giuseppe L, Attilio G, Edoardo DN, Loredana G, Cristina L, Vincenzo L. Ovarian function after cancer treatment in young women affected by Hodgkin disease (HD). Hematology. 2007;12(2):141-7.

5.         Chen H, Li J, Cui T, Hu L. Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy induced premature ovarian failure in premenopausal women. The Cochrane database of systematic reviews. 2011(11):Cd008018.

6.         Behringer K, Wildt L, Mueller H, Mattle V, Ganitis P, van den Hoonaard B, et al. No protection of the ovarian follicle pool with the use of GnRH-analogues or oral contraceptives in young women treated with escalated BEACOPP for advanced-stage Hodgkin lymphoma. Final results of a phase II trial from the German Hodgkin Study Group. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2010;21(10):2052-60.

7.         Demeestere I, Brice P, Peccatori FA, Kentos A, Gaillard I, Zachee P, et al. Gonadotropin-releasing hormone agonist for the prevention of chemotherapy-induced ovarian failure in patients with lymphoma: 1-year follow-up of a prospective randomized trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013;31(7):903-9.

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

9.         Song G, Gao H, Yuan Z. Effect of leuprolide acetate on ovarian function after cyclophosphamide-doxorubicin-based chemotherapy in premenopausal patients with breast cancer: results from a phase II randomized trial. Medical oncology (Northwood, London, England). 2013;30(3):667.

10.       Karimi-Zarchi M, Forat-Yazdi M, Vafaeenasab MR, Nakhaie-Moghadam M, Miratashi-Yazdi A, Teimoori S, et al. Evaluation of the effect of GnRH agonist on menstrual reverse in breast cancer cases treated with cyclophosphamide. European journal of gynaecological oncology. 2014;35(1):59-61.

11.       Moore HC, Unger JM, Phillips KA, Boyle F, Hitre E, Porter D, et al. Goserelin for ovarian protection during breast-cancer adjuvant chemotherapy. The New England journal of medicine. 2015;372(10):923-32.

I Study ID

 II Method

III Patient characteristics

IV Intervention(s)

V Results

VII Critical appraisal of study quality

• Reference

• Design
• Source of funding
• Setting
• Sample size
• Duration

• Eligibility criteria
• A priori patient characteristics
• Group comparability

• Intervention(s)
• Comparator(s)

• Effect size

• Risk of bias

• [Letourneau 2012]

• Retrospective survey

No CoI

California, USA

Sample size n=545

Survey was in 2010

Quality of Life was assessed with 3 validated scales: Decision Regret Scale (DRS), the satisfaction with Life Scale (SWLS), and the brief World Health Organisation QoL questionnaire

• Women of reproductive age (age at diagnosis 18-40) from the cancer registry who had a history of leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer, or gastrointestinal cancer

Women were diagnosed with cancer between 1993 and 2007

• A priori patient characteristics: not reported for the two groups
• Group comparability: not reported for the two groups

Counseling oncology alone (n=505)

vs.

Counseling oncology team and fertility specialist (n=40)

Decisional regret score

Whether patients regretted their decision to undergo (or not undergo) FP (5-item scale), higher score, higher regret.

Oncology alone (n=505) mean score 11.0 ± 5.0

Oncology team and FS (n=40) mean score 8.4 ± 4.4 (p<0.0001)

Decisional conflict

Not reported

• High risk of bias
• Retrospective survey
• Recall bias: Retrospective completion of the questionnaires
• Selection bias: a significant proportion of eligible participants were not reached
• Not all confounding factors could be controlled for status regarding current disease state.

• [Peate 2012]

• Non-randomized trial
• No CoI
• Australia
• Sample size n=120 (participants who completed at least one questionnaire)
• 2006 to 2009
• Questionnaires:

- 10-item low literacy version of the Decisional Conflict scale [3]

- 5-item Decision regret scale[4]

• Women 18-40 years of age, diagnosed with invasive breast cancer, proficient in English, pre-menopausal at time of diagnosis, not yet havinf commenced adjuvant therapy, interest in having a child
• A priori characteristics: mean age 33.8 vs. 32.3; parity 36.1 vs. 25.0
• There were no significant differences in demographics

Decision aid (DA)

vs.

Usual care (UC)

Decisional regret scale : fertility

High score more regret (5-item scale)

DA 1 mo f-up mean score: 24.4 (sd 19.0) n=43

UC 1 mo f-up mean score: 19.7 (sd 18.9) n=61 p=0.16 after adjustment for education

DA 12 mo f-up mean score: 45.8 (sd 8.97) n=32

UC 12 mo f-up mean score: 49.1 (sd 8.24) n=57 p=0.03 after adjustment for education

• Decisional conflict scale

Score>37.5 indicate high decisional conflict

DA baseline mean score: 51.6 (sd 32.8) n=44

UC baseline mean score: 47.2 (sd 31.0) n=70

DA 1 mo f-up mean score: 16.6 (sd 26.5) n=45

UC 1 mo f-up mean score: 23.1 (sd 30.6) n=64

DA 12 mo f-up mean score: 14.7 (sd 23.7) n=34

UC 12 mo f-up mean socre: 29.3 (30.7) n=58

Ongecorrigeerde β=1.43 (p=0.007)

• High risk of bias since no randomisation, before and after comparison, high loss to follow up and blinding was not possible

Decisional Regret Score (measured with: 5-item scale ; range of scores: 5-25; Better indicated by lower values)

1 [Letourneau 2012]

observational studies

very serious¹

no serious inconsistency

no serious indirectness

serious²

none

40

505

-

Oncology alone (n=505) mean score 11.0 ± 5.0

Oncology team and FS (n=40) mean score 8.4 ± 4.4 (p<0.0001)

+OOO VERY LOW

Decisional Conflict

0

No evidence available

none

-

-

-

-

0%

-

Decisional Regret Scale - 1 month follow up (measured with: 5-item scale to quantify fertility treatment decisions ; range of scores: 0-100; Better indicated by lower values)

1 [Peate 2012]

Non-randomised trials

very serious³

no serious inconsistency

no serious indirectness

serious²

none

43

61

-

DA mean score: 24.4 (sd 19.0)

  UC mean score: 19.7 (sd 18.9)

p=0.16 after adjustment for education

+OOO VERY LOW

Decisional Regret Scale- 12 months follow up (measured with: 5-item scale to quantify fertility treatment decisions ; range of scores: 0-100; Better indicated by lower values)

1 [Peate 2012]

Non- randomised trials

very serious³

no serious inconsistency

no serious indirectness

serious²

none

32

57

-

DA mean score: 45.8 (sd 8.97)

UC mean score: 49.1 (sd 8.24)

p=0.03 after adjustment for education

+OOO VERY LOW

Decisional Confict Scale RCT Baseline (measured with: 10-item low literacy version (regarding different fertility treatments); range of scores: 0-100; Better indicated by lower values)

1 [Peate 2012]

Non- randomised trials

very serious³

no serious inconsistency

no serious indirectness

serious²

none

44

70

-

DA mean score: 51.6 (sd 32.8)

UC mean score: 47.2 (sd 31.0)

+OOO VERY LOW

Decisional Conflict Scale RCT - 1 month Follow up (measured with: 10-item low literacy version (regarding different fertility treatments); range of scores: 0-100; Better indicated by lower values)

1 [Peate 2012]

Non-randomised trials

very serious³

no serious inconsistency

no serious indirectness

serious²

none

45

64

-

DA mean score: 16.6 (sd 26.5)

UC mean score: 23.1 (sd 30.6)

+OOO VERY LOW

Decisional Conflict Scale RCT 12 month follow up (measured with: 10-item low literacy version (regarding different fertility treatments); range of scores: 0-100; Better indicated by lower values)

1 [Peate 2012]

Non-randomised trials

very serious³

no serious inconsistency

no serious indirectness

serious²

none

34

58

-

DA mean score: 14.7 (sd 23.7)

UC mean socre: 29.3 (30.7)

+OOO VERY LOW

[1]      Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, et al. Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer. 2012; 118: 1710-7.

[2]      Peate M, Meiser B, Cheah BC, Saunders C, Butow P, Thewes B, et al. Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. British journal of cancer. 2012; 106: 1053-61.

[3]      O'Connor AM. Validation of a decisional conflict scale. Medical decision making : an international journal of the Society for Medical Decision Making. 1995; 15: 25-30.

[4]      Brehaut JC, O'Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, et al. Validation of a decision regret scale. Medical decision making : an international journal of the Society for Medical Decision Making. 2003; 23: 281-92.