Case Report

FERTILITY AFTER GESTATIONAL TROPHOBLASTIC

NEOPLASIA: A CASE OF SUCCESSFUL PREGNANCY
OUTCOME AFTER SINGLE-AGENT CHEMOTHERAPY
TREATMENT

Yohanes Satrya Wibawa, Kartiwa Hadi Nuryantoa

a)
Division of Oncology Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine
Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital

Abstract
Background: Gestational Trophoblastic Disease (GTD) is a spectrum of interrelated diseases
originating from the placenta, which includes both premalignant and malignant entities. Surgery
and/or chemotherapy were still the standard treatment for patients with GTD which led to major
concerns about whether the treatment may affect the patient’s fertility or furthermore, the
pregnancy and neonatal outcome. Methotrexate (MTX) has been widely used as a first-line single
chemotherapy agent for low-risk Gestational Trophoblastic Neoplasia (GTN) patients. The
administration of MTX remains a concern for clinicians and patients especially in reproductive
ages, as it targets rapid dividing cells, including ovarian and endometrial cells which may affect
subsequent reproductive function, and also increasing the possibility of adverse maternal outcomes
and specific patterns of birth defects.
Case presentation: This case report presents a 29-year-old woman diagnosed with low-risk GTN,
who underwent a complete single chemotherapy agent using MTX, managed to conceive only 1
month after completing the consolidation dose, and went through a successful term pregnancy with
no maternal and fetal complications.
Conclusion: Surveillance after GTN chemotherapy treatment plays an important role in patients
in reproductive ages due to the increased risk of ovarian and endometrial damage, and adverse
pregnancy outcomes.

Keywords: gestational trophoblastic disease, chemotherapy, methotrexate, subsequent

reproductive outcome