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Article: Comparison of the multiples of the median of serum anti‐müllerian hormone and pregnancy outcomes in patients with gestational trophoblastic disease: A case–control study

TitleComparison of the multiples of the median of serum anti‐müllerian hormone and pregnancy outcomes in patients with gestational trophoblastic disease: A case–control study
Authors
KeywordsAnti-müllerian hormone
chemotherapy
gestational trophoblastic neoplasia
molar pregnancy
ovarian reserve
Issue Date28-Mar-2024
PublisherWiley Open Access
Citation
Cancer Medicine, 2024, v. 13, n. 7 How to Cite?
Abstract

Introduction

Chemotherapy is crucial in treating gestational trophoblastic neoplasia (GTN), but its impact on gonadotoxicity is unclear.

Materials and Methods

This case–control study included 57 GTN patients and 19 age-matched patients with molar pregnancies (MP) in 2012–2018. Multiples of the median (MoM) of the serum AMH levels were compared between the two groups, and between patients using single-agent and combination chemotherapy, at baseline, 6, 12, and 24 months after treatment. Their pregnancy outcomes were also compared.

Results

There was no significant difference in the MoM of serum AMH between GTN and MP groups at all time points. Single-agent chemotherapy did not adversely affect the MoM. However, those receiving combination chemotherapy had lower MoM than those receiving single-agent chemotherapy at all time points. The trend of decline from the baseline was marginally significant in patients with combination chemotherapy, but the drop was only significant at 12 months (Z = −2.69, p = 0.007) but not at 24 months (Z = −1.90; p = 0.058). Multivariable analysis revealed that combination chemotherapy did not affect the MoM. There was no significant difference in the 4-year pregnancy rate and the livebirth rate between the single-agent and combination groups who attempting pregnancy, but it took 1 year longer to achieve the first pregnancy in the combination group compared to the single-agent group (2.88 vs. 1.88 years).

Conclusion

This study showed combination chemotherapy led to a decreasing trend of MoM of serum AMH especially at 12 months after treatment, but the drop became static at 24 months. Although pregnancy is achievable, thorough counseling is still needed in this group especially those wish to achieve pregnancy 1–2 years after treatment or with other risk factors.


Persistent Identifierhttp://hdl.handle.net/10722/342142
ISSN
2023 Impact Factor: 2.9
2023 SCImago Journal Rankings: 1.174
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLai, Theodora Hei Tung-
dc.contributor.authorLau, Lesley Suk Kwan-
dc.contributor.authorNgu, Siew Fei-
dc.contributor.authorChu, Man Yee Mandy-
dc.contributor.authorChan, Karen Kar Loen-
dc.contributor.authorNg, Ernest Hung Yu-
dc.contributor.authorNgan, Hextan Yuen Sheung-
dc.contributor.authorLi, Raymond Hang Wun-
dc.contributor.authorTse, Ka Yu-
dc.date.accessioned2024-04-09T07:30:02Z-
dc.date.available2024-04-09T07:30:02Z-
dc.date.issued2024-03-28-
dc.identifier.citationCancer Medicine, 2024, v. 13, n. 7-
dc.identifier.issn2045-7634-
dc.identifier.urihttp://hdl.handle.net/10722/342142-
dc.description.abstract<h3>Introduction</h3><p>Chemotherapy is crucial in treating gestational trophoblastic neoplasia (GTN), but its impact on gonadotoxicity is unclear.</p><h3>Materials and Methods</h3><p>This case–control study included 57 GTN patients and 19 age-matched patients with molar pregnancies (MP) in 2012–2018. Multiples of the median (MoM) of the serum AMH levels were compared between the two groups, and between patients using single-agent and combination chemotherapy, at baseline, 6, 12, and 24 months after treatment. Their pregnancy outcomes were also compared.</p><h3>Results</h3><p>There was no significant difference in the MoM of serum AMH between GTN and MP groups at all time points. Single-agent chemotherapy did not adversely affect the MoM. However, those receiving combination chemotherapy had lower MoM than those receiving single-agent chemotherapy at all time points. The trend of decline from the baseline was marginally significant in patients with combination chemotherapy, but the drop was only significant at 12 months (<em>Z</em> = −2.69, <em>p</em> = 0.007) but not at 24 months (<em>Z</em> = −1.90; <em>p</em> = 0.058). Multivariable analysis revealed that combination chemotherapy did not affect the MoM. There was no significant difference in the 4-year pregnancy rate and the livebirth rate between the single-agent and combination groups who attempting pregnancy, but it took 1 year longer to achieve the first pregnancy in the combination group compared to the single-agent group (2.88 vs. 1.88 years).</p><h3>Conclusion</h3><p>This study showed combination chemotherapy led to a decreasing trend of MoM of serum AMH especially at 12 months after treatment, but the drop became static at 24 months. Although pregnancy is achievable, thorough counseling is still needed in this group especially those wish to achieve pregnancy 1–2 years after treatment or with other risk factors.</p>-
dc.languageeng-
dc.publisherWiley Open Access-
dc.relation.ispartofCancer Medicine-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAnti-müllerian hormone-
dc.subjectchemotherapy-
dc.subjectgestational trophoblastic neoplasia-
dc.subjectmolar pregnancy-
dc.subjectovarian reserve-
dc.titleComparison of the multiples of the median of serum anti‐müllerian hormone and pregnancy outcomes in patients with gestational trophoblastic disease: A case–control study-
dc.typeArticle-
dc.identifier.doi10.1002/cam4.7134-
dc.identifier.scopuseid_2-s2.0-85189146651-
dc.identifier.volume13-
dc.identifier.issue7-
dc.identifier.eissn2045-7634-
dc.identifier.isiWOS:001192135000001-
dc.identifier.issnl2045-7634-

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