Pregnancy outcome of giving large doses of oral progesterone in early endometrial cancer and endometrial severe dysplasia / 中国医师进修杂志

ABSTRACT

Objective To explore the pregnancy outcome of large doses of progesterone conservative treatment in early endometrial cancer and endometrial severe dysplasia and analyze the pregnancy-relating factors.Methods Fifty-eight cases with early endometrial cancer and 33 cases with endometrial severe dysplasia from June 2008 to January 2013 were selected.They were given large doses of oral progesterone,endometrial curettage was used to evaluate the therapy response of endometrium after every 3 months of administration.Individualized maintained treatment was given to patients after achieving complete remissionof the endometrium.Pregnancy outcome and pregnancy-relating factors were analyzed retrospectively.Results All of the 91 patients 87.9％ (80/91) achieved complete response.Of the 61 cases who desired to conceive after complete response,29 of them had 35 pregnancies,the pregnant rate was 47.5 ％ (29/61),and 22 women obtained healthy live birth baby,the fertility rate was 36.1％ (22/61).Age,pre-treatment complications,treatment time and treatment before endometrial biopsy result (endometrial severe atypical hyperplasia or endometrial cancer) was not correlated with pregnancy (P ＞0.05).The pregnant rate of patients who received in vitro fertilization-embryo transfer,ovulation promotion,or no treatment was 13/13,12/29 and 4/19,respectively,and there was significant difference (P ＜0.05).Conclusions Conservative treatment for early endometrial cancer and endometrial severe dysplasia with large doses progesterone could achieve higher response rate.Assisted reproductive technologies could significantly increase the chance of conception.