title: [Pregnant rate and pregnancy-relating factors of patients with early endometrial carcinoma and severe atypical hyperplasia of endometrium after fertility-preserving treatment by progestin].
abstract: OBJECTIVE
  To summarize the pregnant rate of patients with early endometrial carcinoma and severe atypical hyperplasia after fertility-preserving treatment and analyze their pregnancy-relating factors.
  
  
  METHODS
  Endometrial curettage was used to evaluate the therapy response of endometrium after every 3 months of administration of high-dose progestin as fertility-sparing treatment for 51 patients with stage I endometrial carcinoma or severe endometrial atypical hyperplasia from Jun. 1996 to Jan. 2010. Individualized maintained treatment was given to patients after achieving complete remission of the endometrium. Pregnant results and pregnancy-relating factors were analyzed retrospectively.
  
  
  RESULTS
  The median age of all the 51 patients was 29 years old. Forty-five (88%, 45/51) achieved complete response. Of the 34 cases who desired to conceive after complete response, 16 of them had 22 pregnancies, the pregnant rate was 47% (16/34); and 12 women obtained healthy live birth baby, the fertility rate was 35% (12/34). The pregnant rate of patients at age >35 or ≤ 35 was 0/2 and 50% (16/32) respectively (P > 0.05). The pregnant rate of patients with or without infertility was 40% (8/20) and 8/14, with endometrial cancer or severe atypical hyperplasia was 40% (10/25) and 6/9, respectively (all P > 0.05). The pregnant rate of patients who received in vitro fertilization-embryo transfer, ovulation promotion, or no treatment was 7/7, 6/16 and 3/11 respectively (P < 0.01).
  
  
  CONCLUSIONS
  Fertility-preserving treatment for early endometrial cancer and severe atypical hyperplasia with high-dose progestin could achieve higher response rate. Assisted reproductive technologies could significantly increase the chance of conception.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Dong-yan
authors.initials: DY
authors.lastname: Cao
authors.forename: Mei
authors.initials: M
authors.lastname: Yu
authors.forename: Jia-xin
authors.initials: JX
authors.lastname: Yang
authors.forename: Keng
authors.initials: K
authors.lastname: Shen
authors.forename: Hui-fang
authors.initials: HF
authors.lastname: Huang
authors.forename: Ning-hai
authors.initials: NH
authors.lastname: Cheng
authors.forename: Zheng-yi
authors.initials: ZY
authors.lastname: Sun
authors.forename: Cheng-yan
authors.initials: CY
authors.lastname: Deng
authors.forename: Qi
authors.initials: Q
authors.lastname: Yu
authors.forename: Fang-fang
authors.initials: FF
authors.lastname: He
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D004714:Endometrial Hyperplasia / Q000188:drug therapy* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004717:Endometrium / Q000187:drug effects / Q000473:pathology; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000628:therapy; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000627:therapeutic use; D019290:Megestrol Acetate / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011372:Progestins / Q000008:administration & dosage / Q000627:therapeutic use*; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011372:Progestins; D008525:Medroxyprogesterone; D019290:Megestrol Acetate