| Research purposes1.Observe changes in serum anti-Mullerian hormone(AMH)levels from before chemotherapy to after chemotherapy to evaluate the effect of chemotherapy on ovarian function in patients with gynecologic malignancy.2.To study the protective effects of GnRH analogues(mainly leuprolide,goserelin)to evaluate the function of ovarian reserve,and to provide a reference for the protection of ovarian function during chemotherapy for young gynecological cancer patients.Research methodsIn accordance with the principle of informed consent,40 serum samples were collected before chemotherapy and after chemotherapy three days(relatively complete chemotherapy cycles)for young gynecological cancer patients who were initially treated in the Third Affiliated Hospital of Kunming Medical University between January 2016 and December 2017.Among them,20 cases of GnRH analogues(mainly leuprolide,goserelin)were used to protect ovarian function during chemotherapy,and 20 cases of GnRH analogues were not used to protect ovarian function during chemotherapy.The same patients before chemotherapy,AMH changes and AHM changes after chemotherapy as the criterion,the GnRH analogues before chemotherapy and the unused AMH values were used as the experimental group and the control group.Analyze and evaluate different chemotherapy regimens,the number of different chemotherapy courses,the effect of GnRH analogues on ovarian function in different ages of chemotherapy,and the effect of chemotherapy drugs on ovarian.function.Through the determination of FSH,E2,LH,and AMH,the damage to ovarian function after chemotherapy was evaluated.Research result1,the analysis of the overall data:control group:the first course of chemotherapy:AMH:3.6255 ± 1.8668 P<0.05,second-course chemotherapy:AMH:1.1770±1.2952 P = 0.443 was not statistically significant,the third-course chemotherapy:AMH:0.3007±0.4281 P<0.05,fourth-course chemotherapy:AMH:0.0267±0.0289 P<0.05,fifth-course chemotherapy:AMH:0.0100±0.000 P<0.05.Experimental group:The first course of chemotherapy:AMH:2.2390±1.0586 P<0.05,the second course of chemotherapy:AMH:0.7635±0.6697 P=0.228 without statistical difference,the third course of chemotherapy:AMH:0.2623±0.4858 P<0.05,Four-way chemotherapy:AMH:0.0933 ± 0.8958 P<0.05,fifth-course chemotherapy:AMH:0.0350 ± 0.0.3536 P<0.05.The first and last chemotherapy in the experimental group and the control group were compared with each other:the control group:AMH3.1850±1.9735 P<0.05.Experimental group:AMH:1.9735±1.2189 P<0.05.2.Follow-up menstruation:3 months after chemotherapy,15 cases of menstrual cramps in the experimental group,1 case died,and 9 cases of menstrual cramps in the control group.Six months after the end of chemotherapy,18 cases of menstruation occurred in the experimental group,2 cases died,and 20 cases of the control group had menstrual cramps.3.Comparative analysis of FSH,LH and E2:Experimental group:FSH before chemotherapy:5.3360±0.6224,LH:15.0780±5.9138,E2:143.9560±19.6376,FSH after chemotherapy:14.81070±2.7383,LH:20.8933±4.52158,E2:59.3980±13.1862.Control group:FSH:5.3780±0.7584,LH:13.6373±5.4995.,E2:152.6715±13.1373.4.For the data of chemotherapy patients at different ages in this study,there was no statistical significance between the experimental group and the control group aged 17 to 21?22 to 27,and 28 to 39 years old.In conclusion1.Compare the control group of the total data with the experimental group.With the increase of the chemotherapy course,the chemotherapeutic drugs will aggravate the damage to the ovary both in the control group and the experimental group.Analysis of statistical data,GnRH-a has a protective effect on ovarian function during chemotherapy,can slow the rate of decline in ovarian function,but can not specify the specific role of time and effectiveness of the time.This provides a basis for the clinical evaluation of chemotherapy for ovarian function damage and the use of GnRH-a.2.Follow-up menstruation,ovarian function recovery in the experimental group was significantly better than that in the control group at 3 months of chemotherapy,and in the chemotherapy group or experimental group in June after chemotherapy,ovarian function had a certain recovery.It indicated that the ovary had certain self-repairing function after the chemotherapeutic drug injury,but the protective effect of GnRH-a on the ovary was obvious.3.through the two groups of FSH,LH,E2 and AMH comparative analysis.Explains the effect of chemotherapy on ovarian function damage and the reliability of AMH in assessing ovarian reserve function.4.For the patients of different ages in this study,statistical data were analyzed.The effect of chemotherapy on ovarian function and the protective effect of GnRH-a on ovarian function was not related to age. |
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