Successful pregnancy in an infertile patient with conservatively treated endometrial adenocarcinoma after transfer of embryos obtained by intracytoplasmic sperm injection.
A rare case of successful pregnancy in a woman with early-stage endometrial adenocarcinoma conservatively treated is presented. The patient, having polycystic ovaries, was initially diagnosed with hyperplasia of the endometrium and treated with several cycles of ovulation induction following intrauterine insemination. Then dilatation and curettage were carried out when hysteroscopy was performed. The histology report identified a well-differentiated adenocarcinoma of the endometrium. After repeated endometrial curettage, in-vitro fertilization and embryo transfer were introduced for immediate treatment of the patient's infertility in order to avoid the risk of recurrence of neoplastic endometrial lesions by oestrogens. A single pregnancy was achieved after transfer of the embryos obtained after intracytoplasmic sperm injection. This was performed due to the poor semen characteristics (asthenozoospermia). The patient delivered a healthy normal male infant at term. A transvaginal ultrasound examination 2 months after delivery showed a smooth, linear endometrium. Moreover, the histology report after endometrial biopsy was free of any malignancies. The patient now desires another pregnancy. We conclude that conservative treatment of early-stage endometrial adenocarcinoma in young women wishing to preserve fertility should be considered in carefully selected cases. Assisted reproductive technologies may be helpful for immediate achievement of pregnancy in such patients.
Shibahara
H
H
Department of Obstetrics and Gynecology, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Shigeta
M
M
Toji
H
H
Wakimoto
E
E
Adachi
S
S
Ogasawara
T
T
Takemura
T
T
Koyama
K
K
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000328:Adult; D003593:Cytoplasm; D004107:Dilatation and Curettage; D004624:Embryo Transfer; D016889:Endometrial Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000150:complications* / Q000628:therapy*; D008297:Male; D008845:Microinjections; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D011256:Pregnancy Outcome; D011379:Prognosis; D012099:Reproductive Techniques; D013094:Spermatozoa