[The effect of etoposide on ovarian function in patients with gestational trophoblastic disease]

Thirty-four patients with low risk gestational trophoblastic disease were treated with etoposide alone. Within 60 days after treatment, synthetic luteinizing hormone releasing hormone (LH-RH: 100 micrograms) was injected intravenously. The serum concentrations of LH, follicle-stimulating hormone (FSH) before and 30, 60, 120 minutes after LH-RH administration, estradiol (E2) and progesterone were measured. In addition, the basal body temperature (BBT) was taken continuously to evaluate ovulation. (1) The patients aged 40 or more in whom serum LH and FSH levels were higher before LH-RH administration, showed excessive response to LH-RH. These excessive responses were 45.5% and 7.1% in patients in their thirties and twenties, respectively. (2) Serum E2 and progesterone levels decreased with advanced age, which was not affected by total doses of etoposide. (3) Seven (77.8%) patients over 40 years were found to have anovulatory cycles, based on their BBT, and ovulation was confirmed in all the patients under 40 years. (4) Eleven pregnancies were confirmed. Nine delivered apparently healthy infants. The influence of etoposide on ovarian function was transient except for patients over 40 years old.