Overview of literature on fertility and reproductive outcomes after gestational trophoblastic neoplasia treated with single agent or multi-agent chemotherapy
| Reference | Chemotherapy | Women with pregnancy wish n | Pregnant women n | Total pregnancies n | Outcome of pregnancies | |||||||
| Miscarriage n (%) | TOP n (%) | Ectopic n (%) | Live birth n (%) | Preterm birth n (%) | Stillbirth n (%) | Cong abn n (%) | Repeat mole n (%) | |||||
| Ross55 | Single agent n=88 Multi-agent n=18 | 106 | 58 49 7 | 96 | 15 (15.6) | ND | ND | 78 (81.3) | ND | 3 (3.1) | 3 (3.1) | ND |
| Hsieh et al62 | MTX or ACT-D MTX/ACT-D/CP | ND | 11 | 13 | 2 (15.4) | ND | ND | 10 (76.9) | ND | ND | 1 (7.7) | ND |
| Song et al63 | Single agent (6-MP, 5-FU, KSM, MTX) n=91 Multi-agent n=107 | ND | 205 | 355 | 26 (7.3) | 23 (6.5) | 2 (0.6) | 303 (85.4) | 20 (5.6) | 3 (0.8) | 3 (0.8) | 2 (0.6) |
| Ngan et al64 | Etoposide MTX ACT-D Multi-agent | 41 | ND | 41 | 6 (14.6) | 2 (4.9) | 0 (0) | 32 (78) | 1 (2.4) | 0 (0) | ND | 0 (0) |
| Kjer et al65 | MTX/VC/ACT-D/CP MTX/ACT-D | 30 | 29 | 62 | 6 (9.7) | ND | 1 (1.6) | ND | ND | ND | ND | 1 (1.6) |
| Ayhan et al66 | CHM prophylaxis MTX n=43 MTX n=2 MX/ACT-D n=3 MTX/ACT-D/CP n=1 | ND | 49 | 65 | 8 (12.3) | 7 (10.8) | ND | 42 (64.6) | 4 (6.2) | 1 (1.5) | 0 (0) | 3 (4.6) |
| Kim et al16 | ND | ND | 38 | 50 | 9 (18) | ND | 1 (2) | 33 (66) | 4 (8) | 0 (0) | 1 (2) | 3 (6) |
| Woolas et al35 | Single agent n=396 Multi-agent n=336 | 728 | 680 | ND | ND | ND | ND | 1000 | ND | ND | ND | 18 () |
| Amr et al67 | MTX EMA/CO MAC | 55 | 42 | 120 | 7 (5.8) | ND | 1 (0.8) | 94 (78.3) | 15 (12.5) | 3 (2.5) | 2 (1.7) | ND |
| Braga et al41 | MTX or ACT-D n=167 EMA/CO, MAC, CHAMOCA, EP/EMA n=85 | ND | ND | 252 | 42 (16.7) | ND | ND | 172 (68.3) | 6 (2.4) | 2 (0.8) | 6 (2.4) | 7 (2.8) |
| Vargas et al20 | ND | ND | ND | 667 | 123 (18.4) | 28 (4.2) | 7 (1) | 446 (66.9) | 44 (6.6) | 10 (1.5) | 12 (1.8) | 9 (1.3) |
| Williams et al56 | MTX or ACT-D n=745 EMA/CO n=459 | ND | 244 | 255 | 33 (12.9) | 25 (9.8) | 5 (2) | 187 (73.3) | 14 (5.5) | 1 (0.4) | ND | 4 (1.6) |
| Matsui et al42 | MTX or ACT-D or ETO n=295 MEA or MAC n=83 | 133 | 129 | 243 | 27 (11.1) | 35 (14.4) | ND | 169 (69.5%) | 2 (0.8) | 5 (2.1) | ND | 5 (2.1) |
Cong abn, congenital abnormalities; ACT-D, actinomycin D; CHAMOCA, cyclophosphamide, hydroxyurea, actinomycin D, methotrexate, doxorubicin, melphalan, vincristine ; CHM, complete hydatidiform mole; CP, cyclophosphamide; EMA/CO, etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine; EP/EMA, etoposide, cisplatin, etoposide methotrexate, actinomycin D; 5-FU, 5-fluorouracil; KSM, kasugamycin, strain of streptomycetes; MAC, methotrexate, actinomycin D, chlorambucil; MEA, methotrexate, etoposide, actinomycin D; 6-MP, 6-mercaptopurine; MTX, methotrexate; ND, not described; TOP, termination of pregnancy; VC, vincristine.