Recurrent gestational trophoblastic disease following in-vitro fertilization

Hum Reprod. 1994 Nov;9(11):2010-3. doi: 10.1093/oxfordjournals.humrep.a138384.

Abstract

Recurrence of gestational trophoblastic disease (GTD) following two attempts at in-vitro fertilization (IVF)/embryo transfer is reported in a childless couple after 17 years of unsuccessful trials of ovulation induction. The diagnosis of bilateral tubal obstruction was finally established, indicating IVF treatment. After the first IVF/embryo transfer treatment, the woman developed GTD and was treated with methotrexate. After a second IVF attempt, GTD was again diagnosed. This time there was no response to methotrexate, thus necessitating second-line chemotherapy. Etoposide, methotrexate, actinomycin D, cyclophosphamide, oncovine was used, and after only four treatment cycles the beta-human chorionic gonadotrophin (HCG) dropped to < 5 mIU/ml. After 26 months of follow-up, the beta-HCG continues to be undetectable. Preimplantation evaluation and ovum donation are described as measures to minimize the risk for GTD recurrence in a future IVF/embryo transfer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chorionic Gonadotropin / blood
  • Chorionic Gonadotropin, beta Subunit, Human
  • Cyclophosphamide / administration & dosage
  • Dactinomycin / administration & dosage
  • Embryo Transfer
  • Etoposide / administration & dosage
  • Female
  • Fertilization in Vitro*
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / therapy*
  • Methotrexate / administration & dosage
  • Methotrexate / therapeutic use
  • Peptide Fragments / blood
  • Pregnancy
  • Recurrence
  • Trophoblastic Neoplasms / drug therapy*
  • Uterine Neoplasms / drug therapy*
  • Vincristine / administration & dosage

Substances

  • Chorionic Gonadotropin
  • Chorionic Gonadotropin, beta Subunit, Human
  • Peptide Fragments
  • Dactinomycin
  • Vincristine
  • Etoposide
  • Cyclophosphamide
  • Methotrexate

Supplementary concepts

  • EMA-CO protocol