Reproductive Outcomes After Treatment of Gestational Trophoblastic Neoplasia in Slovakia

Abstract Introduction Gestational trophoblastic neoplasia (GTN) represents the malignant variant of gestational trophoblastic disease (GTD), a rare condition characterized by abnormal trophoblastic cell proliferation. GTN affects mostly women of reproductive age and is characterized by early metastatic progression. The majority of GTN tumors respond well to chemotherapy. The overall cure rate may be as high as 95 to 100 percent. Future pregnancy after treatment is an important issue. The purpose of this study was to analyze reproductive outcomes of GTN patients registered at the Center for GTD of Slovakia. Methods A retrospective analysis of pregnancy outcomes in GTN patients after treatment. The study included all recorded pregnancies in GTN patients treated with systemic therapy at the Center for GTD of Slovakia in 1993–2024. Results A total of 94 pregnancies in 51 patients were included. 44 patients (86.3%) were treated with single-agent chemotherapy and 7 (13.7%) with multi-agent chemotherapy. 41 patients (80.4%) had at least one pregnancy resulting in live birth. Of the 94 pregnancies, 61 (64.9%) resulted in live birth and 17 (18.1%) in miscarriage. Women after single-agent chemotherapy had more live births than women after multi-agent chemotherapy (68.7% vs. 36.4%, p = 0.035). Pregnancies conceived ≥ 12 months after finishing treatment resulted in more live births (25 vs 2; p = 0.004) and less pregnancy terminations (2 vs 8; p < 0.001) compared to those conceived earlier. Conclusion GTN patients can expect a normal course of subsequent pregnancy after treatment with comparable outcomes to the general population.