Effect of actinomycin D on ovarian reserve in low-risk gestational trophoblastic neoplasia.

Abstract

OBJECTIVE:

This study aimed to explore the single-agent chemotherapy actinomycin D on ovarian reserve by measuring the anti-Mullerian hormone (AMH) levels before, during, and after chemotherapy.

METHODS:

This study recruited premenopausal women aged 15 to 45 with a newly diagnosed low-risk gestational trophoblastic neoplasia needing actinomycin D. AMH was measured at baseline, during chemotherapy, and 1, 3, and 6 months after the last chemotherapy. The reproductive outcomes were also documented.

RESULTS:

Of the 42 women recruited, we analyzed 37 (median: 29 years; range 19-45) with a complete dataset. The follow-up was 36 months (range 34-39). Actinomycin D significantly decreased AMH concentrations during treatment, from 2.38±0.92 ng/mL to 1.02±0.96 ng/mL (p<0.05). Partial recovery was seen at 1 month and 3 months after treatment. Full recovery was reached 6 months after treatment among patients younger than 35 years. The only factor correlated with the extent of AMH reduction at 3 months was age (r=0.447, p<0.05). Notably, the number of courses of actinomycin D was not associated with the extent of AMH reduction. A total of 18 (90%) of 20 patients who had a desire to conceive had live births with no adverse pregnancy outcomes.

CONCLUSION:

Actinomycin D has a transient and minor effect on ovarian function. Age is the only factor that impacts the patient's rate of recovery. Patients will achieve favorable reproductive outcomes after actinomycin D treatment.

• Authors: Wei Xue, Wei Cang, Jun Zhao, Fengzhi Feng, Xirun Wan, Tong Ren, Ling Qiu, Junjun Yang, Yang Xiang
• Journal: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society (Int J Gynecol Cancer) Vol. 33 Issue 8 Pg. 1222-1226 (08 07 2023) ISSN: 1525-1438 [Electronic] England
• PMID: 37290904 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

Chemical References

• Dactinomycin
• Anti-Mullerian Hormone

Topics

• Pregnancy
• Humans
• Female
• Dactinomycin (therapeutic use)
• Ovarian Reserve
• Gestational Trophoblastic Disease (drug therapy)
• Pregnancy Outcome
• Anti-Mullerian Hormone