J Korean Med Sci.  2006 Jun;21(3):567-571. 10.3346/jkms.2006.21.3.567.

A Successful Live Birth Through in vitro Fertilization Program After Conservative Treatment of FIGO Grade I Endometrial Cancer

• Park JC
• Cho CH
• Rhee JH

• KMID: 1778447
• DOI: http://doi.org/10.3346/jkms.2006.21.3.567

Abstract

Infertile women with chronic anovulation are prone to be exposed to unopposed estrogen stimulation and have the high risk of being suffering from endometrial hyperplasia or even endometrial carcinoma. A few reports have suggested that nulliparous young women (under 40 yr of age) with endometrial carcinoma could be treated conservatively to preserve fertility and succeed the live birth. We report on a 36-yr-old woman who received conservative treatment of endometrial carcinoma (stage I, grade 1) by curettage and progestin. After megestrol medication of total 71,680 mg during 24 weeks, we found the regression of endometrial lesion by curettage and hysteroscopic examination. Then we decided to perform in vitro fertilization program. Two embryos were transferred and heterotypic pregnancy was diagnosed 27 days after embryo transfer. After right salpingectomy, she received routine obstetrical care and delivered by cesarean section at 38 weeks in gestational periods. Two years after delivery, she is healthy without any evidence of recurrent disease. The fertility preserving treatment is an option in endometrial cancer patients if carefully selected, and assisted reproductive technologies would be helpful.

Keyword

Endometrial Neoplasms; Fertilization in Vitro; Progestins

MeSH Terms

Progestins/therapeutic use
Pregnancy Outcome
Pregnancy
Live Birth
Humans
Fertilization in Vitro/*methods
Female
Endometrial Neoplasms/surgery/*therapy
Adult
Adenocarcinoma/surgery/*therapy

Figure

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  Fig. 1 (A) Hysterosalpingogram shows a small filling defect in the uterine cavity. (B and C) MRI reveals no residual tumor in the endometrium nor myometrial involvement after curettage.

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  Fig. 2 (A) A well-differentiated endometrioid adenocarcinoma. Light micrograph shows anaplastic proliferation of the endometrial glands associated with foci of squamoid differentiation (H&E stain, ×200). (B) After progestin therapy for 8 weeks, the endometrium shows complex hyperplasia without nuclear atypia in the dilated endometrial glands (H&E stain, ×200).

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