***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: PURPOSE Observational studies suggested that luteinizing hormone-releasing hormone agonists ( LHRHa ) might prevent premature ovarian failure result ing from adjuvant chemotherapy in premenopausal patients . We aim ed to test the efficacy of ovarian function preservation with the LHRHa goserelin in patients with breast cancer . PATIENTS AND METHODS In a prospect i ve , r and omized , open-label , controlled multicenter study , 60 patients younger than age 46 years with hormone-insensitive breast cancer were allocated to receive anthracycline/cyclophosphamide ( with or without taxane ) -based neoadjuvant chemotherapy with or without goserelin . The first goserelin injection was administered at least 2 weeks before the first chemotherapy cycle , continuing at 3.6 mg subcutaneously every 4 weeks until the end of the last cycle . The primary objective was the reappearance of normal ovarian function , defined as two consecutive menstrual periods within 21 to 35 days at 6 months after end of chemotherapy . RESULTS Fifty-three patients ( 88.3 % ) experienced temporary amenorrhea ( 93.3 % with v 83.3 % without goserelin ) . No significant difference was observed regarding the reappearance of menstruation at 6 months after chemotherapy ( 70.0 % with v 56.7 % without goserelin ; difference of 13.3 % ; 95 % CI , -10.85 to 37.45 ; P = .284 ) . All but one evaluable patient reported regular menses at 2 years after chemotherapy . Time to restoration of menstruation was 6.8 months ( 95 % CI , 5.2 to 8.4 ) with goserelin and 6.1 months ( 95 % CI , 5.3 to 6.8 ) without goserelin ( P = .304 ) . Chemotherapy result ed in a decreased ovarian reserve measured by inhibin B and anti-Müllerian hormone during follow-up , supporting the other findings . CONCLUSION Premenopausal patients with breast cancer receiving goserelin simultaneously with modern neoadjuvant chemotherapy did not experience statistically significantly less amenorrhea 6 months after end of chemotherapy compared with those receiving chemotherapy alone Background Recent breast cancer treatment guidelines recommend that higher-risk premenopausal patients should receive ovarian function suppression ( OFS ) as part of adjuvant endocrine therapy . If chemotherapy is also given , it is uncertain whether to select concurrent or sequential OFS initiation . Design and methods We analyzed 1872 patients enrolled in the r and omized phase III TEXT and SOFT trials who received adjuvant chemotherapy for hormone receptor-positive , HER2-negative breast cancer and upon r and omization to an OFS-containing adjuvant endocrine therapy , initiated gonadotropin-releasing-hormone-agonist triptorelin .  Breast cancer-free interval ( BCFI ) was compared between patients who received OFS concurrently with chemotherapy in TEXT ( n = 1242 ) versus sequentially post-chemotherapy in SOFT ( n = 630 ) . Because timing of trial enrollment relative to adjuvant chemotherapy differed , we implemented l and mark analysis re-defining BCFI beginning 1 year after final dose of chemotherapy ( median , 15.5 and 8.1 months from enrollment to l and mark in TEXT and SOFT , respectively ) . As a non-r and omized treatment comparison , we implemented comparative-effectiveness propensity score methodology with weighted Cox modeling . Results Distributions of several clinico-pathologic characteristics differed between groups . Patients who were premenopausal post-chemotherapy in SOFT were younger on average . The median duration of adjuvant chemotherapy  was 18 weeks in both groups . There were 231 ( 12 % ) BC events after post-l and mark median follow-up of about 5 years . Concurrent use of triptorelin with chemotherapy was not associated with a significant difference in post-l and mark BCFI compared with sequential triptorelin post-chemotherapy , either in the overall population ( HR = 1.11 , 95 % CI 0.72 - 1.72 ; P = 0.72 ; 4-year BCFI 89 % in both groups ) , or in the subgroup of 692 women < 40 years at diagnosis ( HR = 1.13 , 95 % CI 0.69 - 1.84 ) who are less likely to develop chemotherapy-induced amenorrhea . Conclusion Based on comparative-effectiveness modeling of TEXT and SOFT after about 5 years median follow-up , with limited statistical power especially for the subgroup < 40 years , neither detrimental nor beneficial effect of concurrent administration of OFS with chemotherapy on the efficacy of adjuvant therapy that includes chemotherapy was detected . Clinical trials.gov NCT00066690 and NCT00066703 Background Chemotherapy-induced premature ovarian insufficiency ( POI ) impacts fertility and other aspects of women 's health . The OPTION trial tested whether administration of a gonadotropin-releasing hormone agonist during chemotherapy for early breast cancer reduced the risk of POI . Patients and methods This was a prospect i ve , r and omized , parallel group study of the gonadotropin-releasing hormone agonist goserelin administered before and during  chemotherapy  for breast cancer with stage I-IIIB disease . The primary outcome was amenorrhoea between 12 and 24 months after r and omization , supported by elevated follicle stimulating hormone concentrations to give an additional analysis as rate of POI . Results A total of 227 patients were r and omized and the primary analysis was conducted on 202 patients . Goserelin reduced the prevalence of amenorrhoea between 12 and 24 months to 22 % versus 38 % in the control group ( P = 0.015 ) and the prevalence of POI to 18.5 % versus 34.8 % in the control group ( P = 0.048 ) . Follicle stimulating hormone concentrations were also lower in all women treated with goserelin at both 12 and 24 months ( P = 0.027 , P = 0.001 , respectively ) . The effect of goserelin was not statistically significant in women > 40 years . Assessment of the ovarian reserve using anti-Müllerian hormone showed a marked fall in both groups during treatment to median values of 5 % of pretreatment levels in the control group and 7 % in the goserelin group , which were not significantly different between groups . Conclusion This study shows that goserelin reduced the risk of POI in women treated with chemotherapy for early breast cancer , with particular efficacy in women aged ≤40 years old . The degree of ovarian protection also seems limited and the clinical significance for fertility and longer term prevention of estrogen deficiency-related outcomes needs to be determined IMPORTANCE Whether the administration of luteinizing hormone-releasing hormone analogues ( LHRHa ) during chemotherapy is a reliable strategy to preserve ovarian function is controversial owing to both the lack of data on long-term ovarian function and pregnancies and the safety concerns about the potential negative interactions between endocrine therapy and chemotherapy . OBJECTIVE To evaluate long-term results of LHRHa-induced ovarian suppression during breast cancer chemotherapy . DESIGN , SETTING , AND PARTICIPANTS Parallel , r and omized , open-label , phase 3 superiority trial conducted at 16 Italian sites . Between October 2003 and January 2008 , 281 premenopausal women with stage I to III hormone receptor-positive or hormone receptor-negative breast cancer were enrolled . Last annual follow-up was June 3 , 2014 . INTERVENTIONS Patients were r and omized to receive adjuvant or neoadjuvant chemotherapy alone ( control group ) or chemotherapy plus triptorelin ( LHRHa group ) . MAIN OUTCOMES AND MEASURES The primary planned end point was incidence of chemotherapy-induced early menopause . Post hoc end points were long-term ovarian function ( evaluated by yearly assessment of menstrual activity and defined as resumed by the occurrence of at least 1 menstrual cycle ) , pregnancies , and disease-free survival ( DFS ) . RESULTS A total of 281 women ( median age , 39 [ range , 24 - 45 ] years ) were r and omized . Median follow-up was 7.3 years ( interquartile range , 6.3 - 8.2 years ) . The 5-year cumulative incidence estimate of menstrual resumption was 72.6 % ( 95 % CI , 65.7%-80.3 % ) among the 148 patients in the LHRHa group and 64.0 % ( 95 % CI , 56.2%-72.8 % ) among the 133 patients in the control group ( hazard ratio [ HR ] , 1.28 [ 95 % CI , 0.98 - 1.68 ] ; P = .07 ; age-adjusted HR , 1.48 [ 95 % CI , 1.12 - 1.95 ] ; P = .006 ) . Eight pregnancies ( 5-year cumulative incidence estimate of pregnancy , 2.1 % [ 95 % CI , 0.7%-6.3 % ] ) occurred in the LHRHa group and 3 ( 5-year cumulative incidence estimate of pregnancy , 1.6 % [ 95 % CI , 0.4%-6.2 % ] ) in the control group ( HR , 2.56 [ 95 % CI , 0.68 - 9.60 ] ; P = .14 ; age-adjusted HR , 2.40 [ 95 % CI , 0.62 - 9.22 ] ; P = .20 ) . Five-year DFS was 80.5 % ( 95 % CI , 73.1%-86.1 % ) in the LHRHa group and 83.7 % ( 95 % CI , 76.1%-89.1 % ) in the control group ( LHRHa vs control : HR , 1.17 [ 95 % CI , 0.72 - 1.92 ] ; P = .52 ) . CONCLUSIONS AND RELEVANCE Among premenopausal women with either hormone receptor-positive or hormone receptor-negative breast cancer , concurrent administration of triptorelin and chemotherapy , compared with chemotherapy alone , was associated with higher long-term probability of ovarian function recovery , without a statistically significant difference in pregnancy rate . There was no statistically significant difference in DFS for women assigned to triptorelin and those assigned to chemotherapy alone , although study power was limited . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00311636 OBJECTIVE To determine whether GnRHa administration before and during combination chemotherapy for breast cancer could preserve posttreatment ovarian function in young women or not . DESIGN Prospect i ve r and omized controlled study . SETTING Department of Obstetrics and Gynecology , Mansura University Hospital , Mansura , Egypt . PATIENT(S ) Eighty patients with unilateral adenocarcinoma of the breast and with no metastasis who had undergone modified radical mastectomy or breast-conserving surgery plus full axillary lymph node dissection were included in the study . Patients were assigned r and omly to receive combined GnRHa and chemotherapy or chemotherapy alone . One woman in each group dropped out . MAIN OUTCOME MEASURE(S ) Return of spontaneous menstruation and ovulation . Hormonal changes ( FSH , LH , E(2 ) , P ) during and after the course of treatment . RESULT ( S ) In the study group , 89.6 % resumed menses and 69.2 % resumed spontaneous ovulation within 3 - 8 months of termination of the GnRHa/chemotherapy cotreatment ; 11.4 % experienced hypergonadotrophic amenorrhoea and ovarian failure 8 months after treatment . In the control group ( chemotherapy without GnRHa ) , 33.3 % resumed menses and 25.6 % resumed normal ovarian activity . The median FSH and LH concentrations , 6 months after completion of the GnRHa/chemotherapy cotreatment group , were significantly less than the control group . During the GnRHa/chemotherapy cotreatment the concentrations of FSH , LH , and P decreased to almost prepubertal levels . However , within 1 - 3 months after the last GnRHa injection , an increase in LH and FSH concentrations was detected , followed several weeks later in by an increase in P concentrations to within normal levels . CONCLUSION ( S ) GnRHa administration before and during combination chemotherapy for breast cancer may preserve posttreatment ovarian function in women < 40 years . Long-term studies are required PURPOSE Most research regarding fertility in young women with breast cancer has focused on long-term survivors . Little is known about how fertility concerns affect treatment decisions or fertility preservation strategies at the time of initial cancer diagnosis . PATIENTS AND METHODS As part of an ongoing prospect i ve multicenter cohort study , we surveyed women with newly diagnosed early-stage breast cancer at age ≤ 40 years . The baseline survey included sociodemographic , medical , and treatment data as well as a modified Fertility Issues Survey , including fertility concern and preservation items . Univariable and multivariable modeling were used to investigate predictors of greater fertility concern . RESULTS Among the first 620 eligible respondents included in this analysis , median age 
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Conclusion Our findings provide evidence for the efficacy and safety of temporary ovarian suppression with GnRHa during chemotherapy as an available option to reduce the likelihood of chemotherapy-induced POI and potentially improve future fertility in premenopausal patients with early breast cancer