title: Progestin treatment of atypical hyperplasia and well-differentiated adenocarcinoma of the endometrium to preserve fertility.
abstract: OBJECTIVE
  To evaluate the outcome of a cohort of young women treated with progestin for fertility-sparing management of endometrial atypical hyperplasia (AH) and endometrial carcinoma (EC). This retrospective multicentre cohort study included women under the age of 40 years treated conservatively for AH and EC to preserve fertility using progestin for at least 3 months. Four inclusion criteria were defined: (i) the presence of AH or grade 1 EC confirmed by two pathologists (including a reference pathologist); (ii) the use of conservative management for fertility sparing; (iii) adequate radiological examination before conservative management; and (iv) a minimal follow-up time of one year.
  
  
  RESULTS
  Twenty-two patients fulfilled the inclusion criteria (8 had EC, and 14 had AH). After progestin treatment, 17 patients responded. Among the 17 patients who experienced remission, three also experienced disease relapse. One patient initially diagnosed with AH experienced progression of her disease to stage IIIA EC. Ten pregnancies were achieved in eight patients.
  
  
  CONCLUSIONS
  Fertility-sparing management using progestin offers the opportunity to fulfil maternal desires in young patients diagnosed with AH and EC. However, progression of the disease is possible and close follow-up is needed.
authors.affiliation: Department of Obstetrics and Gynecology, Bichat - Claude Bernard Hospital, 46 Rue Henri Huchard, 75018 Paris, France. martin.koskas@wanadoo.fr
authors.forename: Martin
authors.initials: M
authors.lastname: Koskas
authors.forename: Elie
authors.initials: E
authors.lastname: Azria
authors.forename: Francine
authors.initials: F
authors.lastname: Walker
authors.forename: Dominique
authors.initials: D
authors.lastname: Luton
authors.forename: Patrick
authors.initials: P
authors.lastname: Madelenat
authors.forename: Chadi
authors.initials: C
authors.lastname: Yazbeck
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000503:physiopathology; D000328:Adult; D002454:Cell Differentiation; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005298:Fertility; D006801:Humans; D006965:Hyperplasia / Q000188:drug therapy*; D011372:Progestins / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011372:Progestins