title: Pregnancy outcomes after fertility-sparing management in young women with early endometrial cancer.
abstract: OBJECTIVE
  To analyze pregnancy outcomes in young women with stage IA, grade 1 endometrioid adenocarcinoma of the uterus after successful fertility-sparing management using progestin.
  
  
  METHODS
  We reviewed the medical records of 141 women with stage IA, grade 1 endometrioid adenocarcinoma of the uterus who had complete remission after progestin treatment. Statistical analysis was performed using Student's t test or Mann-Whitney U test for continuous variables, using χ or Fisher's exact test for categorical variables, and using log-rank test for survival comparison.
  
  
  RESULTS
  Fifty-four (38.3%) women in the study cohort had a history of infertility. Seventy (49.6%) of the 141 patients tried to conceive with 44 (62.9%) receiving fertility drugs. The median interval to attempted pregnancy after treatment was 5 months (range 1-31 months). The median age at the time of the pregnancy trial was 32.4 years (range 23-40 years). Fifty-one (73%) of 70 women who tried to conceive were successful and 46 (66%) gave birth to 58 live neonates. The spontaneous abortion rate, ectopic pregnancy rate, and preterm delivery rates in our cohort were 24%, 2.8%, and 11.5%, respectively. The 5-year disease-free survival was similar between patients who received fertility drugs (n=44) or who did not (n=97) (73% compared with 62%, P=.335), and this rate was significantly higher in patients who achieved at least one pregnancy (n=51) than those who did not (n=90) (76% compared with 62%, P=.028).
  
  
  CONCLUSIONS
  Although the proportion of patients with a history of subfertility or infertility was high in our cohort, the pregnancy outcomes were very promising using assisted reproductive technology. The use of fertility drugs was not associated with a higher incidence of cancer recurrence after successful fertility-sparing management in this study population.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics, University of Ulsan College of Medicine, Asan Medical Center, Gangnam, Korea.
authors.forename: Jeong-Yeol
authors.initials: JY
authors.lastname: Park
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Kim
authors.forename: Jae Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Seok Mo
authors.initials: SM
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D018269:Carcinoma, Endometrioid / Q000188:drug therapy*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D005260:Female; D005299:Fertility Agents / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000188:drug therapy; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D019290:Megestrol Acetate / Q000627:therapeutic use*; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011271:Pregnancy, Ectopic / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D005299:Fertility Agents; D017258:Medroxyprogesterone Acetate; D019290:Megestrol Acetate