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The aim of this study was to determine the influence of cytotoxic chemotherapy on subsequent reproductive performance. Details of post-treatment reproductive intent and outcome were requested from 1211 survivors registered at The Charing Cross Hospital gestational trophoblastic disease centre; a response rate of 96% was achieved. Seven hundred and twenty-eight women had tried to become pregnant; 607 reported at least one live birth, 73 conceived but had not registered a live birth, and 48 did not conceive. No differences were apparent between the 392 women who received methotrexate as single agent chemotherapy and the 336 treated with multi-agent chemotherapy. Women who had registered a live birth were younger (P < 0.0001) and the duration of follow up was significantly less among those who did not achieve pregnancy at all (P < 0.0003). A higher than expected rate of caesarean section and stillbirth was recorded. The chemotherapy protocols used by this unit have minimal impact on the subsequent ability to reproduce.