Invitro Fertilization in Infertile Patients with Endometrial Cancer

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To assess the effectiveness of intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF) and embryo transfer (IVF-ET) in infertile patients with early-stage endometrial cancer (EC) or atypical endometrial hyperplasia (AEH).

Patients with well-differentiated, early-stage EC or AEH who achieved complete reversion of the endometrium after conservative treatment and who underwent IVF-ET between January 2012 and December 2015 were collected. The fertilization rate, implantation rate, pregnancy rate, and AEH/EC recurrence rate were measured.

A total of 31 patients were included, of whom 25 (80.65%) had AEH and 6 (19.35%) had well-differentiated early-stage EC. The mean duration of conservative treatment was 8.25±4.08 months, while the mean age at entering the IVF cycle was 34.9±3.8 years. The average number of embryos transferred was 1.7 ± 0.8. The IVF and ICSI fertilization rates were 77.6% and 68.2%, respectively. The implantation and pregnancy rates were 29.6% (16/54) and 41.9% (13/31), respectively. There were 13 cases of intrauterine pregnancy with a clinical pregnancy rate of 41.9%. Recurrence of the endometrial lesion occurred in 2 (6.45%) patients.

We conclude that endometrial lesions do not impair the IVF process and that outcomes after complete reversion of the endometrium lesion are similar to those seen for the general population.

Assisted reproductive technology is a good option in well-selected patients with early-stage EC or AEH who show complete reversion of the endometrial lesion after conservative therapy. Nonetheless, additional longer-term studies are needed to compare disease recurrence rates and live birth rates between patients given infertility treatment after complete reversion of the endometrium and those not given infertility treatment.

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Regards,
Robert John
Editorial Manager
Journal of Womens Health and Reproductive Medicine