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Practice Point
Ovarian function suppression – Use of GnRH agonist #2
If a gonadotropin-releasing hormone (GnRH) agonist is used in premenopausal women, it should be given on a monthly basis to optimise ovarian suppression.
If a GnRH agonist is used in this age group, it should be given on a monthly basis (and not a 3-monthly basis) to optimise ovarian suppression. (Level of evidence – moderate)
Weak recommendation, moderate quality evidence. Weak recommendation, best action may differ depending on circumstances or patients' or societal values
Recommendations for adjuvant GnRH agonist use are based on data from trials with monthly administration. Thus, current guidelines support monthly use to optimize ovarian function suppression, particularly in very young women (<35 years of age) and in those receiving an AI
A 3-monthly use may be considered on a case-by-case basis with very close monitoring of ovarian function, when monthly use is not feasible or accepted by the patient
How this guidance was developed
This recommendation was adopted from the ESO-ESMO 2017 guidelines for young women (Europe). The source recommendation was based on a review of the evidence (date not reported) and was graded ‘B’ (using ACCP methods) by the source guideline authors. The updated ESO-ESMO 2020 recommendations on this topic indicate the strength of the recommendation to be ‘Expert opinion’ (a different grading system was used). As the recommendation is based on the 2017 source recommendation, the allocation of ‘recommendation’ rather than ‘practice point’ remains.
Related guidance by topic
Ovarian function suppression – Use of GnRH agonist #2
Practice Point
If a gonadotropin-releasing hormone (GnRH) agonist is used in premenopausal women, it should be given on a monthly basis to optimise ovarian suppression.
Principles in action
Safe and quality care
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Multidisciplinary care
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Care coordination
This recommendation was adopted from the ESO-ESMO 2017 guidelines for young women (Europe). The source recommendation was based on a review of the evidence (date not reported) and was graded ‘B’ (using ACCP methods) by the source guideline authors. The updated ESO-ESMO 2020 recommendations on this topic indicate the strength of the recommendation to be ‘Expert opinion’ (a different grading system was used). As the recommendation is based on the 2017 source recommendation, the allocation of ‘recommendation’ rather than ‘practice point’ remains.
Related guidance by topic
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