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Fertility outcomes of patients with early stage endometrial carcinoma
Author(s) -
Parlakgumus Huriye Ayse,
Kilicdag Esra Bulgan,
Simsek Erhan,
Haydardedeoglu Bulent,
Cok Tayfun,
Aytac Pinar Caglar,
Bagis Tayfun,
Erkanlı Serkan
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12132
Subject(s) - medicine , carcinoma , stage (stratigraphy) , fertility , gynecology , curettage , obstetrics , surgery , population , paleontology , environmental health , biology
Aim Three to five percent of endometrial carcinoma patients are younger than 40 years and may desire fertility. Conservative treatment can be employed in these cases. We aimed to review treatment outcomes of patients who were diagnosed with endometrial carcinoma and who wanted to preserve their fertility. Material and Methods We reviewed nine patients who were diagnosed with early stage endometrial carcinoma and wanted to spare their fertility. The patients were followed up at B askent U niversity A dana R esearch C enter from J anuary 2004 to D ecember 2011. Results In all patients the carcinoma presented as polyps, which were resected by hysteroscopy. After being informed about both surgical and medical therapies, four patients preferred surgery and five preferred medical treatment. The mean number of in vitro fertilization trials after conservative treatment was 3.25. One woman, who was on medroxyprogesterone acetate, delivered a healthy term baby from a fresh cycle. Another woman, who was on dydrogesterone, got pregnant from a thawing cycle, which later ended up in a missed abortus. Of all the patients who chose medical treatment, three had surgery at the end. One woman developed an ovarian tumor during the follow‐up; one woman had a recurrence of endometrial carcinoma on dilatation and curettage for missed abortus and one woman tried in vitro fertilization several times and could not get pregnant, thus decided to have surgery. Two women had stage IA endometrial carcinoma and one had stage IIB ovarian carcinoma. Conclusion Conservative treatment of endometrial carcinoma is safe in most cases. However, patients should be well‐informed about the risks of conservative treatment because delaying definitive treatment sometimes worsens the prognosis.