Influence of chemotherapy for gestational trophoblastic disease on subsequent pregnancy outcome

• Published in: BJOG : an international journal of obstetrics and gynaecology 1998-09, Vol.105 (9), p.1032-1035
• Main Authors: Woolas, Robert P., Bower, Mark, Newlands, Edward S., Seckl, Michael, Short, Dee, Holden, Lydia
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age of Onset; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Drug toxicity and drugs side effects treatment; Female; Follow-Up Studies; Humans; Medical sciences; Pharmacology. Drug treatments; Pregnancy; Pregnancy Outcome; Reproductive Medicine; Toxicity: urogenital system; Trophoblastic Tumor, Placental Site - drug therapy; Uterine Neoplasms - drug therapy
• ISSN: 1470-0328; 0306-5456; 1471-0528; 1365-215X
• DOI: 10.1111/j.1471-0528.1998.tb10271.x

The aim of this study was to determine the influence of cytotoxic chemotherapy on subsequent reproductive performance. Details of post‐treatment reproductive intent and outcome were requested from 1211 survivors registered at The Charing Cross Hospital gestational trophoblastic disease centre; a response rate of 96% was achieved. Seven hundred and twenty‐eight women had tried to become pregnant; 607 reported at least one live birth, 73 conceived but had not registered a live birth, and 48 did not conceive. No differences were apparent between the 392 women who received methotrexate as single agent chemotherapy and the 336 treated with multi‐agent chemotherapy. Women who had registered a live birth were younger (P < 0.0001) and the duration of follow up was significantly less among those who did not achieve pregnancy at all (P < 0.0003). A higher than expected rate of caesarean section and stillbirth was recorded. The chemotherapy protocols used by this unit have minimal impact on the subsequent ability to reproduce.