The Analysis of in vitro Fertilization Outcomes after Fertility-Preserving Therapy for Endometrial Hyperplasia or Carcinoma.

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Gynecologic and Obstetric Investigation Pub Date : 2024-01-01 Epub Date: 2024-05-22 DOI:10.1159/000539315
JiEun Park, Eun Jeong Yu, Nara Lee, Jae Eun Park, Seok Ju Seong, Woo Sik Lee, Hee Jun Lee
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引用次数: 0

Abstract

Objectives: This study aimed to evaluate the clinical efficacy of fertility-preserving therapy through in vitro fertilization (IVF) procedures in women who were pathologically diagnosed with endometrial hyperplasia or carcinoma.

Design: A retrospective cohort study on fertility-preserving therapy was conducted. Participants/Materials, Setting: A total of 82 women were enrolled who had simple endometrial hyperplasia (SH), complex hyperplasia (CH), complex atypical hyperplasia (CAH), and endometrioid endometrial carcinoma stage IA (EC IA) and underwent IVF at Gangnam CHA fertility center between January 2008 and December 2020.

Methods: The primary endpoints were oncologic outcomes and subsequent reproductive outcomes of patients who underwent fertility-preserving treatments analyzed by χ2 test or Fisher's exact test.

Results: Of the 82 patients, 33 had a cumulative clinical pregnancy (40.2%), and 25 had a cumulative live birth (30.5%) through IVF procedures following pathologic confirmation of complete remission or non-progressive status. The cumulative clinical pregnancy rates and live birth rates for SH were 50.0% and 30.0%, for CH were 37.8% and 28.9%, for CAH were 25.0% and 25.0%, and for EC were 38.5% and 38.5%, respectively. There were no significant differences in cumulative clinical pregnancy rates or live birth rates when comparing the four groups. There was a difference in endometrial thickness between medroxyprogesterone acetate (MPA) treatment group and intrauterine device (IUD) group (p = 0.036); however, there were no significant differences in clinical pregnancy rates among MPA, IUD, and MPA+IUD groups.

Limitations: Because of the retrospective nature of the study, many factors relevant to the treatment decision were not strictly controlled.

Conclusions: All endometrial hyperplasia and carcinoma groups had competent cumulative live birth rates by IVF procedures. There may be differences in endometrial thickness depending on the treatment methods, but this does not affect clinical pregnancy rates. Therefore, the fertility-preserving treatment for endometrial hyperplasia and carcinoma is a safe and feasible method that results in good IVF outcomes.

分析子宫内膜增生或癌变保留生育力治疗后的试管婴儿结果。
研究目的本研究旨在评估通过体外受精(IVF)程序对病理诊断为子宫内膜增生或癌变的妇女进行生育力保留治疗的临床疗效:设计:对保留生育力疗法进行回顾性队列研究。参与者/材料、环境:2008年1月至2020年12月期间,共有82名患有单纯子宫内膜增生症(SH)、复杂性增生症(CH)、复杂性非典型增生症(CAH)和子宫内膜样内膜癌IA期(EC IA)的妇女在江南CHA生殖中心接受了体外受精:主要终点为接受保留生育力治疗的患者的肿瘤学结果和后续生育结果,通过χ2检验(卡方检验)或费雪精确检验进行分析:在82名患者中,有33人在病理证实病情完全缓解或无进展后通过试管婴儿手术累计临床妊娠(40.2%),25人累计活产(30.5%)。SH的累积临床妊娠率和活产率分别为50.0%和30.0%,CH的累积临床妊娠率和活产率分别为37.8%和28.9%,CAH的累积临床妊娠率和活产率分别为25.0%和25.0%,EC的累积临床妊娠率和活产率分别为38.5%和38.5%。四组患者的累积临床妊娠率和活产率没有明显差异。MPA治疗组和IUD组的子宫内膜厚度存在差异(P=0.036);但MPA组、IUD组和MPA+IUD组的临床妊娠率无明显差异:局限性:由于该研究具有回顾性,许多与治疗决策相关的因素未得到严格控制:所有子宫内膜增生组和癌变组的体外受精累积活产率均合格。治疗方法不同,子宫内膜厚度可能存在差异,但这并不影响临床妊娠率。因此,对子宫内膜增生和癌进行保留生育力的治疗是一种安全可行的方法,可获得良好的试管婴儿结果。
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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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