Abstract
Objective
To summarize the characteristics and outcomes of patients undergoing in vitro fertilization (IVF) after fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer (AH/EC), and to analyze the factors influencing reproductive outcomes and disease recurrence.
Methods
This study retrospectively reviewed the medical records of 125 women who underwent assisted reproductive technology (ART) after fertility-sparing treatment of AH/EC in Peking Union Medical College Hospital from March 2013 to March 2023. Data of clinical features, reproductive outcomes, and recurrence were collected. The primary outcomes were clinical pregnancy and live birth. The secondary outcome was disease recurrence.
Results
A total of 125 patients were involved in the study. The average age to start IVF cycle was 33.66±3.56 years.109 patients underwent at least one embryo transfer. The clinical pregnancy rate and live birth rate per ET were 35.80% and 17.70%, respectively. The cumulative pregnancy rate was 74.31%. The total recurrence rate during IVF was 8%. The younger onset age of AH/EC and controlled ovarian stimulation (COS) with levonorgestrel-releasing intrauterine system (LNG-IUS) were the two factors that were negatively correlated with live birth. COS with LNG-IUS and a history of recurrence before IVF were significantly correlated with the risk of recurrence.
Conclusion
IVF was noted as an effective method to achieve pregnancy in a relatively short period of time, and reproductive outcomes for AH/EC patients were satisfied. Repeated AH/EC treatment was feasible, while recurrence might affect subsequent fertility outcomes. COS with LNG-IUS did not exhibit to have negative effects on obtaining embryos. However, the effects of LNG-IUS on recurrence and endometrial receptivity are still remain unknown, and deserve further assessment.