配合癌症化疗过程中卵巢的保护作用，促性腺激素释放激素类似物（GnRHa）对于准更年期妇女进行造血干细胞移植（HSCT）应该是有利的。本研究的目的是分析GnRHa在准更年期妇女进行HSCT时的益处。回顾性分析了2011年12月至2021年12月之间在北京大学人民医院妇科内分泌门诊进行需保存生育能力的髓毒性化疗HSCT的候选患者。接受GnRHa治疗的患者在髓毒性化疗前至少给予2个疗程的3.75毫克剂量的GnRHa，而未接受GnRHa治疗的患者被纳入对照组。监测所有患者的月经恢复情况、与更年期相关的症状以及HSCT后6-12个月进行的卵巢功能检测（包括卵泡刺激素、黄体生成素和雌二醇）。此外，我们还评估了层流洁净室（LAFR）内患者的阴道出血情况。本研究共纳入了234例患者：治疗组77例和对照组157例。治疗组中层流洁净室内阴道出血的发生率显著低于对照组（24.68% vs. 79.62%，P < 0.001）。治疗组患者的更年期症状在移植后得到缓解（46.75% vs. 19.75%，P < 0.001）。HSCT后随访超声检查两组患者的可见卵泡比例无显著差异（16.88% vs. 13.38%，P = 0.474）。移植后6-12个月的卵泡刺激素水平较低（98.00 mIU/ml vs. 117.53 mIU/ml，P = 0.001）。两组患者中FSH < 40 mIU/ml的比例无显著差异。治疗组中有1例患者恢复了自发性月经，而对照组中无恢复自发性月经的患者（1.30% vs. 0%，P = 0.329）。GnRHa的使用可能会缓解与更年期相关的症状，并减少LAFR内和移植后的突发性出血。GnRHa治疗可以降低髓毒性化疗后FSH的水平，但无法降低在生育年龄的妇女进行髓毒性HSCT后早发性卵巢功能衰竭的发生率。© 2023. Springer Nature Limited.

Gonadotropin-releasing hormone agonist (GnRHa) appears to exhibit ovarian protection during chemotherapy for malignant tumors. The purpose of this study was to analyze the benefits of GnRHa in premenopausal women undergoing hematopoietic cell transplantation (HSCT). Candidates for myeloablative chemotherapy HSCT requiring fertility preservation in the Gynecological Endocrinology Clinic of Peking University People's Hospital from December 2011 to December 2021 were retrospectively analyzed. Patients who chose to receive GnRHa treatment were given at least 2 courses of a 3.75-mg dose of a GnRHa before myeloablative chemotherapy, and patients who chose not to receive GnRHa treatment were included in the control group. All patients were monitored for menstruation return and menopause-related symptoms, and ovarian function tests [follicle-stimulating hormone (FSH), luteinizing hormone, and estradiol] were performed 6-12 months after HSCT. In addition, we assessed the vaginal bleeding of patients in the laminar air-flow room (LAFR). A total of 234 cases were included in this study: 77 cases in the treatment group and 157 cases in the control group. The incidence of vaginal bleeding in the LAFR in the treatment group was significantly lower than that in the control group (24.68% vs. 79.62%, P < 0.001). The menopausal symptoms of the patients in the treatment group were reduced after transplantation (46.75% vs. 19.75%, P < 0.001). There was no difference in visible follicles by follow-up ultrasound in the two groups after HSCT (16.88% vs. 13.38%, P = 0.474). The level of FSH at 6-12 months after transplantation was lower (98.00 mIU/ml vs. 117.53 mIU/ml, P = 0.001). The proportion of patients with FSH < 40 mIU/ml did not differ between the two groups. One patient in the treatment group recovered spontaneous menstruation, while none recovered spontaneous menstruation in the control group (1.30% vs. 0%, P = 0.329). The use of GnRHa may relieve menopause-related symptoms and reduce vaginal bleeding in the LAFR and breakthrough bleeding after transplantation. GnRHa treatment can reduce the level of FSH after myeloablative chemotherapy, but it cannot reduce the incidence of premature ovarian failure in women of reproductive age following myeloablative HSCT.© 2023. Springer Nature Limited.