{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:15:58Z","timestamp":1788426958297,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology & Obste"],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To characterize anti\u2010M\u00fcllerian hormone (AMH) recovery after multiagent chemotherapy for high\u2010risk gestational trophoblastic neoplasia (GTN) and evaluate the impact of regimen and hysterectomy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a retrospective cohort of 68 high\u2010risk GTN patients treated with EMA\/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine,\n n<\/jats:italic>\n \u2009=\u200939) or FAEV (fluorouracil, actinomycin D, etoposide, and vincristine,\n n<\/jats:italic>\n \u2009=\u200929). AMH was measured at baseline, during treatment, and 1 and 6\u2009months after chemotherapy. Generalized estimating equation models assessed associations of regimen and hysterectomy (\n n<\/jats:italic>\n \u2009=\u200918) with longitudinal AMH trajectories. Fertility outcomes were collected in uterus\u2010preserving patients.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Median AMH was 2.73, 0.04, 0.47, and 1.26\u2009ng\/mL at baseline, during treatment, and 1\u2010 and 6\u2010month post\u2010chemotherapy, respectively. By 6\u2009months, 73.5% (50\/68) recovered to AMH \u2265\u20091.0\u2009ng\/mL. FAEV was associated with higher AMH during treatment and at 1\u2009month versus EMA\/CO (geometric mean ratios 2.19 and 2.55; both\n P<\/jats:italic>\n \u2009<\u20090.05) and a higher 6\u2010month recovery rate (86.2% vs. 74.4%). Hysterectomy was associated with higher AMH during treatment (geometric mean ratio 2.25;\n P<\/jats:italic>\n \u2009=\u20090.018) but not with 6\u2010month AMH. Among 28 uterus\u2010preserving patients actively attempting pregnancy, 20 (71.4%) achieved \u2265\u20091 live birth; 6\u2010month AMH was higher in those with live birth (median 1.95 vs. 1.08\u2009ng\/mL; exploratory\n P<\/jats:italic>\n \u2009=\u20090.053).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Multiagent chemotherapy for high\u2010risk GTN causes profound yet partially reversible ovarian reserve suppression, with recovery continuing through at least 6\u2009months. FAEV may be less acutely gonadotoxic than EMA\/CO, and hysterectomy does not appear to compromise longer\u2010term AMH recovery. Six\u2010month AMH may help guide fertility counseling and individualized follow\u2010up.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ijgo.71318","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T08:38:33Z","timestamp":1788424713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal\n AMH<\/scp>\n trajectories, ovarian reserve recovery, and fertility outcomes after multiagent chemotherapy for high\u2010risk gestational trophoblastic neoplasia: A real\u2010world cohort study"],"prefix":"10.1002","author":[{"given":"Wei","family":"Xue","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyi","family":"Chen","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiao","family":"Wu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Ren","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengzhi","family":"Feng","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xirun","family":"Wan","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Xiang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5625-0119","authenticated-orcid":false,"given":"Junjun","family":"Yang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/ijgo.70275","article-title":"Diagnosis and management of gestational trophoblastic disease: 2025 update","volume":"171","author":"Ngan HYS","year":"2025","journal-title":"Int J Gynecol Obstet"},{"issue":"1","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1136\/ijgc-00009577-200101000-00011","article-title":"The new FIGO 2000 staging and risk factor scoring system for gestational trophoblastic disease: description and critical assessment","volume":"11","author":"Kohorn EI","year":"2001","journal-title":"Int J Gynecol Cancer"},{"issue":"3","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.fertnstert.2015.11.020","article-title":"Menses resumption after cancer treatment\u2010induced amenorrhea occurs early or not at all","volume":"105","author":"Jacobson MH","year":"2016","journal-title":"Fertil Steril"},{"issue":"6","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.fertnstert.2020.09.134","article-title":"Testing and interpreting measures of ovarian reserve: a committee opinion","volume":"114","author":"Penzias A","year":"2020","journal-title":"Fertil Steril"},{"issue":"3","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1093\/humupd\/dmac004","article-title":"Anti\u2010M\u00fcllerian hormone as a marker of ovarian reserve and premature ovarian insufficiency in children and women with cancer: a systematic review","volume":"28","author":"Anderson RA","year":"2022","journal-title":"Hum Reprod Update"},{"issue":"2","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.rbmo.2009.11.010","article-title":"Anti\u2010M\u00fcllerian hormone 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childhood, adolescent and young adult cancer survivors: investigating dose\u2010effect relationships in a European case\u2010control study (PanCareLIFE)","volume":"36","author":"Berg MH","year":"2021","journal-title":"Hum Reprod"},{"issue":"7","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","DOI":"10.1002\/cam4.7134","article-title":"Comparison of the multiples of the median of serum anti\u2010m\u00fcllerian hormone and pregnancy outcomes in patients with gestational trophoblastic disease: a case\u2010control study","volume":"13","author":"Lai THT","year":"2024","journal-title":"Cancer Med"},{"issue":"2","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ejogrb.2012.11.021","article-title":"Anti\u2010M\u00fcllerian hormone as a marker of ovarian reserve following chemotherapy in patients with gestational trophoblastic neoplasia","volume":"167","author":"Iwase A","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"1","key":"e_1_2_10_13_1","first-page":"43","article-title":"The effects of chemotherapy on the levels of serum anti\u2010M\u00fcllerian hormone in patients with gestational trophoblastic neoplasia","volume":"24","author":"Zamani M","year":"2023","journal-title":"J Reprod Infertil"},{"issue":"8","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1136\/ijgc-2023-004292","article-title":"Effect of actinomycin D on ovarian reserve in low\u2010risk gestational trophoblastic neoplasia","volume":"33","author":"Xue W","year":"2023","journal-title":"Int J Gynecol Cancer"},{"issue":"1","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s13048-023-01117-1","article-title":"Effect of hysterectomy on ovarian function: a systematic review and meta\u2010analysis","volume":"16","author":"Huang Y","year":"2023","journal-title":"J Ovarian 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