Two successful pregnancies after in vitro fertilization and embryo transfer in a patient with endometrial atypical hyperplasia bordering on adenocarcinoma treated conservatively with high-dose progesterone.
Women suffering from anovulatory infertility may develop endometrial hyperplasia and adenocarcinoma due to the unopposed estrogen effect. We present the case of a young infertile woman with endometrial atypical hyperplasia bordering on adenocarcinoma who refused hysterectomy and bilateral salpingo-oophorectomy and achieved two successful pregnancies after conservative treatment with high-dose progesterone followed by in vitro fertilization and embryo transfer. It is concluded that conservative treatment with high-dose progesterone for endometrial hyperplasia and well-differentiated early-stage adenocarcinoma followed by assisted reproductive technologies is an appropriate means for achieving pregnancy. However, the issue of hysterectomy and bilateral salpingo-oophorectomy after delivery or after fertility being no longer required is controversial. If surgery is not performed, close observation with endometrial sampling every 6 months is advisable.
Piura
Benjamin
B
Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Cancer Research Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. piura@bgumail.bgu.ac.il
D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D000858:Anovulation / Q000150:complications; D004624:Embryo Transfer; D004714:Endometrial Hyperplasia / Q000188:drug therapy*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy*
D011374:Progesterone