Abstract
Background:
A progressive delay in the age of first conception results in an increased frequency of endometrial cancer patients in reproductive age and desiring childbearing.
Case:
A 38-year-old infertile woman with stage I endometrioid adenocarcinoma was treated with gonadotropin releasing hormone agonist (GnRHa) and levonorgestrel-releasing intrauterine device (LNG-IUD). After disease remission, she underwent a controlled ovarian stimulation for standard in vitro fertilization (IVF) program and had a pregnancy delivering a healthy male baby. Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy was performed four months after delivery. The patient is free of disease after 3-year follow-up.
Conclusion:
GnRHa plus LNG-IUD followed by IVF program is a safe and effective fertility-sparing strategy to manage infertile patients with stage I endometrial cancer.
MeSH terms
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Adult
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Antineoplastic Agents, Hormonal / administration & dosage
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Antineoplastic Agents, Hormonal / adverse effects
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Antineoplastic Agents, Hormonal / therapeutic use
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Carcinoma, Endometrioid / drug therapy
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Carcinoma, Endometrioid / pathology
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Carcinoma, Endometrioid / physiopathology
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Carcinoma, Endometrioid / surgery
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Contraceptive Agents, Female / administration & dosage
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Delayed-Action Preparations / administration & dosage
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Delayed-Action Preparations / adverse effects
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Delayed-Action Preparations / therapeutic use
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Endometrial Neoplasms / drug therapy*
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Endometrial Neoplasms / pathology
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Endometrial Neoplasms / physiopathology
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Endometrial Neoplasms / surgery
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Endometrium / drug effects
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Endometrium / pathology
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Female
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Fertility Preservation*
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Fertilization in Vitro*
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Gonadotropin-Releasing Hormone / administration & dosage
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Gonadotropin-Releasing Hormone / adverse effects
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Gonadotropin-Releasing Hormone / agonists*
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Gonadotropin-Releasing Hormone / therapeutic use
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Humans
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Infertility, Female / drug therapy
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Infertility, Female / etiology
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Infertility, Female / therapy*
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Intrauterine Devices, Medicated*
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Leuprolide / adverse effects
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Leuprolide / therapeutic use
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Levonorgestrel / administration & dosage*
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Neoplasm Staging
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Pregnancy
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Remission Induction
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Term Birth
Substances
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Antineoplastic Agents, Hormonal
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Contraceptive Agents, Female
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Delayed-Action Preparations
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Gonadotropin-Releasing Hormone
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Levonorgestrel
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Leuprolide