Obstetrics & Gynecology

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Obstetrics & Gynecology:
doi: http://10.1097/AOG.0b013e31827a0643
Original Research

Pregnancy Outcomes After Fertility-Sparing Management in Young Women With Early Endometrial Cancer

Park, Jeong-Yeol MD, PhD; Seong, Seok Ju MD, PhD; Kim, Tae-Jin MD, PhD; Kim, Jae Weon MD, PhD; Kim, Seok Mo MD, PhD; Bae, Duk-Soo MD, PhD; Nam, Joo-Hyun MD, PhD

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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 χ2 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.

LEVEL OF EVIDENCE: II

© 2013 The American College of Obstetricians and Gynecologists

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