Projekt

Evaluating the protective effect of GnRHa, a randomized clinical study

We will conduct a Swedish multicentric randomized clinical trial and a Nordic population-based registry study to investigate if co-treatment with GnRH agonist drugs during systemic chemotherapy treatment can prevent ovarian follicle loss and protect the fertility of young women and girls undergoing cancer treatment. For this new project (see project outline in the next pages) funding has been granted by the Swedish Research Council and by the Swedish Cancer Society. The debate on ovarian protection using GnRHa has gone on for over 35 years and we would like to provide with an answer by performing a well-designed multicentric, randomized-controlled, double-blind study including appropriate clinical outcomes for fertility and modern biochemical markers of ovarian reserve and also by using the data collected in the population-based Nordic registries. If GnRHa co-treatment can be associated with increased fertility, such treatment would be particularly suitable for very young patients that require immediate cancer therapy and do not have the opportunity to perform any established and time-demanding fertility preservation treatments. However, if the GnRHa co-treatment doesn’t show any protective effects, research should move on attempting to finding therapies that can prevent infertility in our youngest cancer patient population.

Fertility in female cancer survivors after ART

A project to follow survivors of cancer who become pregnant using assisted reproductive treatments including oocyte donation has been completed by doctoral student Anna Marklund, MD and gyn/ob specialist at Södersjukhuset. Her project has special focus on women with breast cancer. This project will encompass the prospective investigation of fertility aspects of female cancer survivors and including the performance of fertility preservation, as well as their obstetrical and perinatal otucomes. Colleagues from all university hospitals in Sweden have joined the network and our project is multicentric with national coverage, including all centers in Sweden that have developed programs for fertility preservation. Our national research collaboration has been successful and effective, and now we plan to use the  model for the investigation of women and men with lymphoma (Postdoc project Frida Lundberg), women and men with sarcoma (PhD project Tobias Lekberg) and women with gynecologic cancer (Oncologist Hanna Röjlar). 

Risks and long term outcomes of ART

In our epidemiological research, large databases using medical population-based registries are being used for identification of risks of ART procedures in specific patient groups including pregnancy complications and long-term outcomes of the mothers and the children. We have recently submitted our manuscript on childhood mortality after ART vs natural conceptions, a study that analysed data from 2.847.815 children born in Sweden and registered in the Medical Birth Registry (Rodriguez-Wallberg et al, 2020). We are currently conducting a long-term follow-up study on the growth and development of children born in Stockholm after ART treatments.

Reproductive outcomes after ovarian cancer

The clinical and reproductive outcomes in women with early ovarian cancer that undergo fertility-sparing surgery are being investigated by doctoral candidate Gry Johansen, MD, gyn/ob specialist at Karolinska Hospital. The project is running nationwide, with collaboration from all 7 centers located at University Hospitals and will collect data prospectively for 3-years.

Publikationer

/Laura Bush