title: Levonorgestrel-releasing intrauterine system for atypical endometrial hyperplasia.
abstract: BACKGROUND
  Endometrial carcinoma is the most common gynaecologic malignancy in the world and develops through preliminary stages of endometrial hyperplasia. Typical endometrial hyperplasia suggests a significant pre-malignant state with frank progression to endometrial carcinoma. Because atypical endometrial hyperplasia tends to occur at a young age, it has become increasingly important and necessary to find a safe and effective fertility-sparing treatment with better tolerability and fewer side effects than the options for treatment that are currently available. The levonorgestrel-releasing intrauterine system has already been used to provide endometrial protection in women with breast cancer who are on adjuvant tamoxifen. The antiproliferative function of levonorgestrel is thought to reduce the risk of endometrial hyperplasia.
  
  
  OBJECTIVE
  To determine the efficacy and safety of the levonorgestrel-releasing intrauterine system in reversing atypical endometrial hyperplasia.
  
  
  METHODS
  In November 2012 we searched the Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library; MEDLINE; EMBASE; and the China National Knowledge Infrastructure for relevant trials. Attempts were made to identify trials from references in published studies. We also searched for ongoing trials in five major clinical trials registries.
  
  
  METHODS
  Randomised controlled trials (RCTs) of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus progestin therapy in women with a confirmed histological diagnosis of simple or complex endometrial hyperplasia with atypia.
  
  
  METHODS
  No eligible study was found.
  
  
  RESULTS
  We did not identify any studies which met our full inclusion criteria.
  
  
  CONCLUSIONS
  There is no evidence available from randomised controlled trials regarding the efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) for atypical endometrial hyperplasia. RCTS are required to determine whether the LNG-IUS is safe and effective for treating atypical endometrial hyperplasia.
authors.affiliation: Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.forename: Bing
authors.initials: B
authors.lastname: Luo
authors.forename: Ying
authors.initials: Y
authors.lastname: Zheng
authors.forename: Heng
authors.initials: H
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Neil
authors.initials: N
authors.lastname: Sidell
mesh_terms: D004714:Endometrial Hyperplasia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*
chemical_list: D016912:Levonorgestrel