Ovarian tissue cryopreservation prior to chemotherapy in patients with Hodgkin’s disease: Is it justified?

Objective: To examine wether ovarian tissue cryopreservation (OTCP) prior to chemotherapy is justified in patients with Hodgkin’s disease. Design: Retrospective analysis. Materials and Methods: The study included 8 patients who underwent OTCP and were treated by monthly injections of GnRH-a prior to chemotherapy (Group A) and 12 patients who undergo OTCP (Group B).The age range in group A was 19–29 years compared to 21–39 in group B. Following clinical staging,OTCP, and GnRH-a administration, patients in group A were treated with ABVD (doxorubincin, bleomycin, vinblastine, dacarbazine) protocol. All patients in group B were treated by ABVD protocol only, two patients were additionally treated by radiotherapy above the diaphragm and in one patient the MOPP (nitrogen mustard, vincristine, prednisone, procarbazine) protocol was added. Results: Six months following the end of chemotherapy menstrual cycle resumed in all patients in group A and in four patients who had amenorrhe in group B. Eight patients in group B had regular menstrual cycles during and after chemotherapy. No patient in either group suffered from ovarian failure. Two patients in group A conceived in the first year since the end of chemotherapy, one patient gave birth to twins and the other underwent termination of pregnancy. Conclusion: Menstrual cycle is temporarily affected during therapy with ABVD in patients with Hodgkin’s disease. OTCP combined with GnRHa and ABVD affects menstrual cycle and ovarian function similar to that of ABVD only. Since no patient developed ovarian failure, we conclude that OTCP is not routinely justified,if at all, in young patients with Hodgkin’s disease.