Journal of Reproductive Medicine Gynaecology & Obstetrics Category: Medical Type: Commentary

A Commentary to Analysis of Fertility Prognosis and Risk Factors in Patients Post-Gestational Trophoblastic Disease

Chaoliang Zhang1,2 and Mingxia Gao1,2*

1 First School of Clinical Medicine, Lanzhou University, Lanzhou, China
2 Reproductive Medicine Center, First Hospital of Lanzhou University, No.1 Dong Gang Xi Road, Chengguan District, Lanzhou, Gansu Province, China

*Corresponding Author(s):
Mingxia Gao
Reproductive Medicine Center, First Hospital Of Lanzhou University, No.1 Dong Gang Xi Road, Chengguan District, Lanzhou, Gansu Province, China
Tel:+86 17739809265,
Email:gaomx05@163.com

Received Date: Dec 31, 2024
Accepted Date: Jan 16, 2025
Published Date: Jan 23, 2025

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.

Literature Overview

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].

Evaluation Method

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].

Discussion of Data and Results

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].

Evaluation of Cited Literature

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.

Conclusion

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.

Conflict of Interest

The authors declare no conflict of interest.

References

  1. Wang R, Ge Y, Dong X, Wang H, Wang L, et al. (2024 ) Analysis of Fertility Prognosis and Risk Factors in Patients Post-Gestational Trophoblastic Disease. Reprod. Sci 31: 3095-3101.
  2. Seckl MJ, Sebire NJ, Berkowitz RS (2010) Gestational trophoblastic disease. Lancet 376: 717-729.
  3. Joneborg U, Coopmans L, van Trommel N, Seckl M, Lok CAR (2021) Fertility and pregnancy outcome in gestational trophoblastic disease. Int J Gynecol Cancer 31: 399-411.
  4. Chen J, Kwan LC, Ma LY, Choi HY, Lo YC, et al. (2021) Retrospective and prospective hindsight bias: Replications and extensions of Fischhoff (1975) and Slovic and Fischhoff (1977). Journal of Experimental Social Psychology 96: 104154.
  5. Wang X, Ji X (2020) Sample Size Estimation in Clinical Research: From Randomized Controlled Trials to Observational Studies. Chest 158: 12-20.
  6. Garcia MT, Lin LH, Fushida K, Francisco RP, Zugaib M (2016) Pregnancy outcomes after chemotherapy for trophoblastic neoplasia. Rev Assoc Med Bras 62: 837-842.
  7. Tal R, Seifer DB, Wantman E, Baker V, Tal O (2018) Antimüllerian hormone as a predictor of live birth following assisted reproduction: an analysis of 85,062 fresh and thawed cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for 2012-2013. Fertil Steril 109: 258-265.
  8. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, et al. (2010) Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update 16: 113-130.
  9. Al Riyami N, Al Riyami M, Al Hajri AT, Al Saidi S, Salman B, et al. (2019) Gestational Trophoblastic Disease at Sultan Qaboos University Hospital: prevalence, risk factors, histological features, sonographic findings, and outcomes. Oman Med J 34: 200-204.

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.


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