| Objective:To evaluation of the effect of chemotherapy on ovarian function and investigate the protective effect on ovarian function of GnRH-a in young patients during chemotherapy.Methods:Collected 30 patients(18-35years),who underwent gynecological malignancies,require preserving fertility function and doing regular chemotherapy in Jan.2016 to Sep.2017 in General Hospital of Ningxia Medical University.According to the wishes of patients and their families,14 cases of GnRH-a were approved during chemotherapy,that is,was the study group;There are 16 cases refused to use GnRH-a,that is,as the control group.Low estrogen symptoms(Kupperman Index?8)and menstrual disorders in the two groups were observed.The effects of chemotherapy on ovarian function were evaluated.To detect the expression of AMH in serum before and during chemotherapy,to evaluate the effect of chemotherapy on ovarian function and whether GnRH-a can protect ovarian function during chemotherapy;To detect the expression of AMH in serum in 1,3 and 6 months after the chemotherapy in the two groups and follow-up their menstrual recovery,to evaluate the recovery of ovarian function in the two groups after chemotherapy and to evaluate again whether GnRH-a can protect the ovarian damage caused by chemotherapy.Results:1.Both groups have menstrual disorders and low estrogen symptoms during chemotherapy occured.The occurrence of menstrual disorders study group is higher than the control group,the difference was not statistically significant(P>0.05).The incidence of low estrogen symptoms,the study group is higher than the control group,but the difference is statistically significant(P<0.05).2.The serum AMH levels of the two groups decrease with the duration of chemotherapy,which is of statistical significance(Ftime=85.559,P=0.000).The difference of serum AMH levels in the two groups is also statistically significant(Finterblock=4.177,p=0.045).At the same time,according to the result of two independent samples t-test,Serum AMH levels in the study group and control group before chemotherapy is no statistically significant difference between the two groups(t=1.760,P>0.05).the serum AMH values of the study group and control group after one time of chemotherapy(t = 1.049,P>0.05)and there is no significant difference in serum AMH level.After 3 times of chemotherapy((t =26.881,P<0.05),after complete end of chemotherapy(t=25.285,P<0.05),serum AMH values of the study group and control group has statistically significant.3.In the six months after the chemotherapy,the proportion of menstrual recovery of the study group is higher than that in the control group,but the difference isn't statistically significant.The recovery time mean of the study group was less than the control group with statistically significance(P<0.05).4.The serum AMH levels recovered after the chemotherapy,which is of statistical significance(Ftime=40.201,P = 0.000).The difference of serum AMH levels in the two groups is also statistically significant(finterbilock=5.789,P=0.023).At the same time,according to the result of two independent samples t-test,the serum AMH values of the study group and control group before the chemotherapy(t=1.760,P>0.05),there is no significant difference in serum AMH level.1 month(t=7.693,P<0.05),3 months(t=6.262,,P<0.05),6 months(t=9.578,P<0.05)after the chemotherapy,serum AMH values of the study group and control group have statistically significant.5.Before chemotherapy the serum AMH level of patients with ovarian malignant tumor is lower than that of the GTN patients,the difference was statistically significant(,P<0.05).However,serum AMH levels in two groups both show a firstly downward and then rising trend before chemotherapy,during chemotherapy,and after chemotherapy.Conclusion:1.Chemotherapy has a clear damaging effect on ovarian reserve function and there is a positive correlation with the time of chemotherapy.2.5-FU and KSM,can also cause a sharp decline in serum AMH levels in patients.3.The application of GnRH-a during chemotherapy has certain protective effect on ovarian function in the process of chemotherapy,it is conducive to the recovery of normal menstruation after chemotherapy. |
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