Abstract
Purpose
To elucidate the problems in infertility treatment for women after conservative therapy for endometrial cancer (EC) or atypical complex endometrial hyperplasia (ACEH).
Methods
The clinical outcomes of 21 patients who underwent assisted reproductive technology after conservative therapy (group A) and 42 control women (group B) were retrospectively analyzed.
Results
There was no significant difference in the number of retrieved oocytes, fertilization rate or the number of transferred embryos between the two groups. Women in group A had a significantly thinner endometrium and a reduced implantation rate compared to those for women in group B. There was no significant difference in the cumulative clinical pregnancy and delivery rates between group A and B. The patients in group A required significantly more embryos for achieving a live-birth.
Conclusions
Our results indicate that a thin endometrium after repeated curettage may have a negative effect on endometrial receptivity of patients after conservative treatment for EC/ACEH. Clinicians should reconsider their present protocols and make efforts to minimize the damage to normal endometrium.
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References
Pellerin GP, Finan MA. Endometrial cancer in women 45 years of age or younger: a clinicopathological analysis. Am J Obstet Gynecol. 2005;193:1640–4.
Park JY, Seong SJ, Kim TJ, Kim JW, Kim SM, Bae DS, et al. Pregnancy outcomes after fertility-sparing management in young women with early endometrial cancer. Obstet Gynecol. 2013;121:136–42.
Gallos ID, Yap J, Rajkhowa M, Luesley DM, Coomarasamy A, Gupta JK. Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis. Am J Obstet Gynecol. 2012;207:266.e1–12.
Dursun P, Erkanli S, Guzel AB, Gultekin M, Tarhan NC, Altundag O, et al. A Turkish Gynecologic Oncology Group study of fertility-sparing treatment for early-stage endometrial cancer. Int J Gynaecol Obstet. 2012;119:270–3.
Ichinose M, Fujimoto A, Osuga Y, Minaguchi T, Kawana K, Yano T, et al. The influence of infertility treatment on the prognosis of endometrial cancer and atypical complex endometrial hyperplasia. Int J Gynecol Cancer. 2013;23:288–93.
Elizur SE, Beiner ME, Korach J, Weiser A, Ben-Baruch G, Dor J. Outcome of in vitro fertilization treatment in infertile women conservatively treated for endometrial adenocarcinoma. Fertil Steril. 2007;88:1562–7.
McLernon DJ, Harrild K, Bergh C, Davies MJ, de Neubourg D, Dumoulin JC, et al. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ. 2010;341:c6945.
Fujimoto A, Fujiwara T, Oishi H, Hirata T, Yano T, Taketani Y. Predictive factors of successful pregnancy after assisted reproductive technology in women aged 40 years and older. Reprod Med Biol. 2009;8:145–9.
Veeck L. In: Veeck L, editor. An atlas of human gametes and conceptuses: an illustrated reference for assisted reproductive technology. New York: Parthenon; 1999. p. 46–51.
Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618–37.
Dumoulin JC, Coonen E, Bras M, van Wissen LC, Ignoul-Vanvuchelen R, Bergers-Jansen JM, et al. Comparison of in-vitro development of embryos originating from either conventional in-vitro fertilization or intracytoplasmic sperm injection. Hum Reprod. 2000;15:402–9.
Zhang X, Chen CH, Confino E, Barnes R, Milad M, Kazer RR. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005;83:336–40.
Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril. 2007;87:53–9.
Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003;18:2337–41.
Shufaro Y, Simon A, Laufer N, Fatum M. Thin unresponsive endometrium–a possible complication of surgical curettage compromising ART outcome. J Assist Reprod Genet. 2008;25:421–5.
Laurelli G, Di Vagno G, Scaffa C, Losito S, Del Giudice M, Greggi S. Conservative treatment of early endometrial cancer: preliminary results of a pilot study. Gynecol Oncol. 2011;120:43–6.
Mazzon I, Corrado G, Masciullo V, Morricone D, Ferrandina G, Scambia G. Conservative surgical management of stage IA endometrial carcinoma for fertility preservation. Fertil Steril. 2010;93:1286–9.
Chang YN, Zhang Y, Wang YJ, Wang LP, Duan H. Effect of hysteroscopy on the peritoneal dissemination of endometrial cancer cells: a meta-analysis. Fertil Steril. 2011;96:957–61.
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Capsule A thin endometrium after repeated curettage may have a negative effect on endometrial receptivity of patients undergoing ART after conservative treatment for EC/AECH.
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Fujimoto, A., Ichinose, M., Harada, M. et al. The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer. J Assist Reprod Genet 31, 1189–1194 (2014). https://doi.org/10.1007/s10815-014-0297-x
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DOI: https://doi.org/10.1007/s10815-014-0297-x