We greatly appreciate Dr Blumenfeld's compliments for our review and his meticulous reading of the text and tables. Concerning his remarks about the results of Waxman et al. , in the fourth paragraph of page 160 of this paper is written 'four of eight women treated with buserelin, and six of nine controls, menstruated after treatment' (italics added by authors). This means, as Dr Blumenfeld states, four out of eight (50%) of patients in the GnRH-a group suffered premature ovarian failure or amenorrhea, but contrary to his interpretation, only three out of nine patients in the control group (33%) ceased menstruating after treatment.
Dr Blumenfeld is correct about the study by Ismail-Khan et al.
[2]: this has been published as an ASCO annual meeting abstract. Given the fact that many studies published on the effectiveness of GnRH-analogues are non-randomized and/or use historical controls, we felt this study, which describes a prospective randomized clinical trial, added useful evidence to our overview. We feel the very robust study design should counteract some of the potential worries on the validity of the results of Ismail-Khan et al.