| Objective:To evaluate the protective effect of GnRH-a on the ovarian function of young patients with ovarian cancer during the course of chemotherapy.Methods:The Cochrane Library,PubMed,Ovid,EMBASE,CNKI,CBM,Wanfang and other databases were searched by computer to screen all the comparative experimental studies on the protection of ovarian function by GnRH-a in the process of postoperative complementary chemotherapy for early ovarian cancer with fertility preserving function.Meanwhile,the related books were also browsed for reference,with the time limit between January 2000 and January 2020.Strictly refer to the inclusion and exclusion criteria for literature screening,data extraction and literature quality evaluation.In case of different opinions,we will discuss with the third party and make a decision.Finally,we use Revman 5.3 software to analyze all the extracted data.Results:After screening,seven studies are strictly included,Chinese studies include six and another is in English,in which there are four randomized controlled trials(RCT)and three non-randomized controlled trials(NRCT).The total sample size was 311 cases,154 in the study group and 157 in the control group.The results of systematic evaluation showed that: 1.The follow up time is from 6 months to half a year after the end of chemotherapy,The number of patients who returned to normal menstruation were recorded.It was found that the proportion of patients who returned to normal menstruation in the study group was higher than that in the control group [or = 14.73,95% CI(5.63,38.51),P < 0.00001],the difference was statistically significant,2.The time of menstruation recovery in the study group was shorter than that in the control group [WMD =-0.97,95% CI(-1.22),-The incidence of premature ovarian failure(POF)in the study group was significantly lower than that in the control group(or = 0.11,95% CI(0.03,0.42),P = 0.001],3.The successful pregnancy rate in the study group was significantly higher than that in the control group [or = 6.08,95% CI(2.43,15.22),P = 0.0001],the difference was statistically significant,4.Gonadal hormone level: in all the literature included,6 articles analyzed the changes of gonadal hormone indexes,all of which showed that follicular stimulating hormone(FSH)in the study group was significantly higher than that in the control group [or = 6.08,95% CI(2.43,15.22),P = 0.0001] The recovery of hormone,FSH,luteinizing hormone(LH),estrogen(E2)was significantly better than that of the control group.Conclusion:The above results show that GnRH-a can protect the ovarian function of young ovarian cancer patients in the process of chemotherapy after the operation of fertility preservation.The main manifestations are: high rate of menstrual recovery,short time of menstrual recovery;low POF incidence;high rate of successful pregnancy and gonadal hormones FSH,LH,E2 The level and degree of recovery were better than that of the control group.It provides a basis for the routine application of GnRH-a in clinical and scientific research.This system uses a reasonable and rigorous retrieval strategy to retrieve major databases at home and abroad.However,due to the small number of related clinical studies,the small number of cases included in the study,the large amount of experimental data collection and other uncontrollable factors,the above conclusions still need further verification and in-depth evaluation of larger sample clinical data and more rigorous research design. |
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