This comment critically evaluates the research article by Rong Wang et al., published in "Reproductive Sciences," which retrospectively analyzes fertility prognosis and risk factors following Gestational Trophoblastic Disease (GTD) treatment [1]. This study is pivotal for advancing fertility management strategies for women affected by GTD.
GTD, a group of diseases primarily affecting women of reproductive age, includes conditions such as hydatidiform mole, invasive hydatidiform mole, and choriocarcinoma, all originating from placental trophoblast cells [2]. Given the potential impacts of GTD treatments on female fertility, this study is integral to enhancing our understanding of fertility outcomes in GTD female [3]. The study cohort comprised 82 patients treated at Lanzhou University First Hospital from 2016 to 2023. Researchers divided the cohort based on pregnancy outcomes-those who achieved subsequent pregnancies and those who did not. They assessed variables such as subsequent pregnancy rates, live birth rates, miscarriage rates, ectopic pregnancy rates, and ongoing pregnancy rates, utilizing logistic regression models to analyze risk factors impacting the re-pregnancy of patients with a history of GTD [1].
The authors employed a retrospective cohort study design, appropriate for identifying risk factors and assessing prognosis. However, the inherent limitations of retrospective data collection, such as information bias and selection bias, could affect the study's findings [4]. The relatively small sample size of 82 cases may further limit the generalizability and reliability of the results. Additionally, sample selection may have regional and temporal limitations, impacting the representativeness of the outcomes [5].
Of the treated GTD patients, 37.74% achieved subsequent pregnancies. The low subsequent pregnancy rate could be attributed to the adverse effects of post-chemotherapy and surgical interventions on fertility [1]. Significantly, a higher proportion of patients in the re-pregnancy group received pre-conception fertility consultations compared to those who did not re-conceive, underscoring the potential benefits of such consultations. The study revealed a negative correlation between the frequency of chemotherapy and re-pregnancy rates, with higher rates observed in patients undergoing single-agent chemotherapy [1,6]. Among re-pregnant GTD survivors, 65% successfully gave birth, while the miscarriage rate stood at 25%, highlighting the need for vigilant monitoring in post-GTD pregnancies [1,7]. Additionally, 5% of these patients experienced ectopic pregnancies, emphasizing the necessity for enhanced fertility monitoring [1,8]. The re-pregnancy rates varied among different histopathological types of GTD, illustrating the distinct challenges each type presents for fertility management post-treatment [1].
The article adeptly incorporates multiple relevant studies to bolster its research framework and interpretation of results. For instance, the epidemiological insights from Al Riyami N et al., [9] and the discussion of fertility-sparing treatments by Ngu SF, Ngan HYS are particularly instructive for understanding GTD's incidence and the implications of various treatment options on fertility [1,6,9]. These citations lend robust theoretical support to the study and elucidate the complex, multidisciplinary nature of GTD management.
This article contributes valuable insights into the fertility prognosis and risk factors for patients with a history of GTD, emphasizing the critical role of pre-conception fertility consultation in enhancing re-pregnancy success rates. Despite limitations such as the small sample size and the retrospective design, the findings offer meaningful guidance for crafting personalized fertility plans for GTD female [1]. Future research should aim to expand the sample size and employ a prospective study design to improve the generalizability and reliability of these results, thereby refining fertility management practices for GTD female.
The authors declare no conflict of interest.
Citation: Zhang C, Gao M (2025) A Commentary to Analysis of Fertility Prognosis and Risk Factors in Patients Post-Gestational Trophoblastic Disease. J Reprod Med Gynecol Obstet 10: 183.
Copyright: © 2025 Chaoliang Zhang, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.