Endometrial abnormalities in infertile women.
OBJECTIVE
To analyze retrospectively the frequency, long-term prognosis and pregnancy rate in infertile women diagnosed with endometrial hyperplasia or carcinoma by endometrial biopsy.


METHODS
From 1989 to 2000, endometrial biopsies were performed on 2,573 patients to investigate the cause of infertility. The main outcome measures were frequency, long-term prognosis and pregnancy rate for patients with each type of endometrial abnormality.


RESULTS
Twenty-four patients (0.93%) were diagnosed with an endometrial abnormality. Of them, 10 were diagnosed with simple hyperplasia, 7 with complex hyperplasia, 3 with complex hyperplasia with atypia and 4 with endometrial carcinoma. All 4 patients (0.16%) with endometrial carcinoma were infertile as a result of complications arising from polycystic ovary syndrome. Two of them underwent hysterectomies. High-dose medroxyprogesterone acetate therapy combined with assisted reproductive technology resulted in pregnancy in 1 of the 2 patients with endometrial carcinoma.


CONCLUSIONS
Of infertile women, 0.93% have endometrial abnormalities, and those with polycystic ovary syndrome have a high risk of endometrial carcinoma. Assisted reproductive technology combined with high-dose medroxyprogesterone acetate may be effective means of overcoming infertility, allowing women with endometrial carcinoma to readily achieve pregnancy.
Kurabayashi
Takumi
T
Department of Obstetrics and Gynecology, Niigata University, Faculty of Medicine, 1-757, Asahimachi-dori, Niigata-shi, Niigata 951-8510, Japan. takumi@med.niigata-u.ac.jp
Kase
Hiroaki
H
Suzuki
Mina
M
Sugaya
Susumu
S
Fujita
Kazuyuki
K
Tanaka
Kenichi
K
D000328:Adult; D002277:Carcinoma / Q000150:complications*; D004714:Endometrial Hyperplasia / Q000150:complications* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007247:Infertility, Female / Q000209:etiology* / Q000473:pathology*; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D011247:Pregnancy; D018873:Pregnancy Rate; D045167:Progesterone Congeners / Q000627:therapeutic use; D011379:Prognosis; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies
D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate