title: Endometrial cancer and fertility.
abstract: OBJECTIVE
  Endometrial cancer can affect reproductive-age women who may desire fertility preservation. This article discusses the current, available data about conservative management of endometrial cancer in young women.
  
  
  RESULTS
  Reproductive-age women with well differentiated endometrial carcinoma have an overall favorable prognosis provided that the tumor is identified at an early, noninvasive stage; however, advanced disease can be present. This article discusses current modalities to evaluate and clinically stage endometrial cancer including hysteroscopy, dilation and curettage, pelvic ultrasound, abdominopelvic computed tomography scan, pelvic magnetic resonance imaging, tumor marker CA125 level, and surgical exploration with laparoscopy or laparotomy. Thorough evaluation is critical as 10 to 29% of young women with endometrial cancer have a synchronous ovarian malignancy. Detailed counseling about the risks and benefits of conservative management, and expectations for fertility after treatment, surveillance, and definitive surgical management is essential. Multiple effective protocols exist for conservative treatment of endometrial cancer, and the initial response rates are as high as 57 to 75%. Successful pregnancies have occurred after conservative management, spontaneously, and with assisted reproductive technologies.
  
  
  CONCLUSIONS
  There are no standard recommendations for selection of appropriate women, treatment protocols, or long-term surveillance for conservative management of clinical stage I endometrial adenocarcinoma, and larger prospective clinical studies are warranted.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA. aydin.arici@yale.edu
authors.forename: Beth W
authors.initials: BW
authors.lastname: Rackow
authors.forename: Aydin
authors.initials: A
authors.lastname: Arici
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D016889:Endometrial Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D010051:Ovarian Neoplasms / Q000556:secondary; D011372:Progestins / Q000627:therapeutic use
chemical_list: D011372:Progestins