Effect of early pregnancy following chemotherapy on disease relapse and fetal outcome in women treated for gestational trophoblastic neoplasia.

OBJECTIVE: To examine the effects of early pregnancy (< 12 months following chemotherapy) on a recent cohort of women treated with modern therapies for gestational trophoblastic neoplasia (GTN). STUDY DESIGN: The Charing Cross GTN database was screened between 1998-2012 to identify 1,204 patients treated with either single-agent (61.9%) or multiagent (38.1%) chemotherapy. RESULTS: A total of 23% of single-agent and 15.4% of the multiagent treatment groups conceived within 12 months of chemotherapy, resulting in 255 early pregnancies, with 73.3% resulting in live births. There was no significant increased risk of miscarriage, ectopic pregnancy, second molar pregnancy or stillbirth as compared to the general U.K. population. Intriguingly, the incidence of relapse was only 1.7% in the early pregnancy group as compared to 5.2% in the 963 patients who did not conceive early. CONCLUSION: Women who become pregnant within 12 months postchemotherapy for GTN can be reassured of a likely favorable outcome, although the safest option is still to delay pregnancy for a year.