RESUMO
Infertility with its psychological and social implications is one of the side effects of chemotherapy especially in young females with various malignant diseases. This study was conducted to assess ovarian function and test the effect of oral contraceptive pills and GnRH a[gnadotrophine releasing hormone agonist] in the protection of ovarian function in cancer cases. Fifty seven young female patients with early stages of malignant diseases were enrolled in this study. Their age ranged between 20-35 years. All patients received alkylating agent based chemotherapy as a chemotherapy for their disease. They were divided into 3 groups. Group [1] included 15 patients who received GnRH agonist 3.6 mg IM monthly. Group [2] included 18 patients who received oral contraceptive pills continuously for the entire duration of the their chemotherapy cycles Group [3] included 24 cases received only chemotherapy. Pre and 6 months post chemotherapy serum hormonal assay which included FSH, estradiol [E2], anti mullerian hormones [AMH], and inhibin-B were carried out for all patients. Ultrasound ovaries was also done. Analysis of the results showed that the use of either GnRH agonist or oral contraceptive pills almost equally helps in the protection of ovarian function in young female patients receiving alkylating agent based regimen. But contraceptive pills are significantly less costly in comparison to GnRH agonists. However, in spite of the apparent short term benefits of these drugs in preserving gonadal function, the hormone derangement which was noticed post chemotherapy may cause premature ovarian failure. The hormonal study AMH and lnhibin-B as well as the ultrasound study to count the number of antral follicles pre and post chemotherapy, are very effective tools to evaluate the condition of the ovaries pre and post treatment