Gestational trophoblastic neoplasia following assisted reproductive technology in a gestational carrier: A case report.

This Iranian case report describes a 30-year-old woman who conceived via IVF after 10 years of secondary infertility and was diagnosed with gestational trophoblastic neoplasia after a partial hydatidiform mole identified by ultrasound and confirmed by uterine endometrial pathology following ultrasound-guided suction curettage. She had persistent or rising β-hCG after the first suction and then presented with severe bleeding and enlarged, cystic ovaries consistent with theca lutein cysts, with imaging suggesting possible myometrial invasion; chest X-ray and other labs were repeatedly normal. She was managed with chemotherapy (weekly methotrexate initially for GTN stage 1 based on β-hCG kinetics, followed by a multi-day methotrexate/leucovorin regimen after ongoing bleeding, with β-hCG monitored to zero in three consecutive tests and continued follow-up planned for 6 months). The report’s key limitation is that it is a single patient case, without systematic comparison or generalizability. Relevance to endometriosis: the patient had a prior laparoscopy for suspected endometriosis, though the paper’s main focus is GTN following IVF.

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