RT Journal Article
SR Electronic
T1 Effect of actinomycin D on ovarian reserve in low-risk gestational trophoblastic neoplasia
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 1222
OP 1226
DO 10.1136/ijgc-2023-004292
VO 33
IS 8
A1 Xue, Wei
A1 Cang, Wei
A1 Zhao, Jun
A1 Feng, Fengzhi
A1 Wan, Xirun
A1 Ren, Tong
A1 Qiu, Ling
A1 Yang, Junjun
A1 Xiang, Yang
YR 2023
UL http://ijgc.bmj.com/content/33/8/1222.abstract
AB Objective This study aimed to explore the single-agent chemotherapy actinomycin D on ovarian reserve by measuring the anti-Mullerian hormone (AMH) levels before, during, and after chemotherapy.Methods This study recruited premenopausal women aged 15 to 45 with a newly diagnosed low-risk gestational trophoblastic neoplasia needing actinomycin D. AMH was measured at baseline, during chemotherapy, and 1, 3, and 6 months after the last chemotherapy. The reproductive outcomes were also documented.Results Of the 42 women recruited, we analyzed 37 (median: 29 years; range 19–45) with a complete dataset. The follow-up was 36 months (range 34–39). Actinomycin D significantly decreased AMH concentrations during treatment, from 2.38±0.92 ng/mL to 1.02±0.96 ng/mL (p<0.05). Partial recovery was seen at 1 month and 3 months after treatment. Full recovery was reached 6 months after treatment among patients younger than 35 years. The only factor correlated with the extent of AMH reduction at 3 months was age (r=0.447, p<0.05). Notably, the number of courses of actinomycin D was not associated with the extent of AMH reduction. A total of 18 (90%) of 20 patients who had a desire to conceive had live births with no adverse pregnancy outcomes.Conclusion Actinomycin D has a transient and minor effect on ovarian function. Age is the only factor that impacts the patient’s rate of recovery. Patients will achieve favorable reproductive outcomes after actinomycin D treatment.Data are available upon reasonable request.