Supplementary Material for: Protecting Effects of Gonadotropin-Releasing Hormone Agonist on Chemotherapy-Induced Ovarian Damage in Premenopausal Breast Cancer Patients: A Systematic Review and Meta-Analysis

Objective: There is no universal consensus on whether gonadotropin-releasing hormone (GnRH) agonist could protect chemotherapy-induced ovarian damage in premenopausal breast cancer patients. This meta-analysis was conducted to estimate the protective effects of GnRH agonist on premenopausal breast cancer patients in details. Methods: PubMed, Cochrane Library, Embase, CNKI and the Chinese Wangfang Database, conference proceedings and clinical trials were searched to find studies reported since 2000. Heterogeneity for the eligible data was assessed and a pooled odds ratio (OR) with 95% confidence interval (CI) was calculated. Results: Resumption of menses rate was improved in the GnRH agonist and chemotherapy-combination groups versus chemotherapy-alone groups (OR = 1.36, 95% CI: 1.19-1.56). Furthermore, the results indicated that spontaneous pregnancy rate was improved in the experimental groups versus the controls (OR = 1.90, 95% CI: 1.06-3.41). In addition, no publication bias was found using a Begg's funnel plot. Conclusion: The results of the current meta-analysis indicate that a GnRH agonist could improve resumption of menses rate and pregnancy rate for premenopausal breast cancer patients. However, more evaluation may be considered to prove this theory.