Successful IVF programme after conservatively treated endometrial cancer

Sodano, Maurizio; Bogliatto, Fabrizio; Morero, S; Mosso, Lorena; Torchio, Bruno; Leidi, L

doi:10.1016/s1472-6483(10)60137-x

Cited by 9 publications

(3 citation statements)

References 23 publications

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“…More than a half of the women who become pregnant used ART, which is in accordance with previous reports (Ramirez et al 2004;Chiva et al 2008). Recent publications demonstrate the effectiveness and the safety of in vitro fertilisation (IVF) in young patients with early stage endometrial cancer treated conservatively (Elizur et al 2007;Sodano 2009). The IVF programme in addition to intracytoplasmic sperm injection (ICSI) may be catalytic to achieve an immediate pregnancy and this is crucial both to minimise the risk for disease relapse and to proceed to the definitive treatment in a reasonable time (Bozdag 2009).…”

Section: Pregnancy Outcomes In Fertility-sparing Treatment Of Patientsupporting

confidence: 82%

Conservative management of young patients with endometrial highly-differentiated adenocarcinoma

Kalogiannidis

Αγοραστός

2011

Journal of Obstetrics and Gynaecology

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Endometrial cancer is uncommon in young women. However, almost 5% of patients are younger than 40 years old. Progestins such as medroxyprogesterone acetate (MPA) and megestrol acetate (MA), have been used as a fertility-sparing approach in this group of patients, with different dose regimens of cyclic (14 days every month) or continuous therapy successfully used. According to the present data, the overall response rate was 73% in a median time of 4 months (range 1-15 months). Endometrial biopsy every 3 months was the common approach to evaluate the patient's response during the treatment. The relapse rate was 36% in a median follow-up time of 22 months (range 6-73 months). Overall, 40% of patients who responded to the treatment successfully, conceived. Half of the patients used assisted reproductive technology to achieve an immediate pregnancy. Although, there are no definite recommendations concerning the conservative management of young patients with early stage endometrial cancer, progestin agents may be used in a selected group of patients for fertility-sparing reasons. After childbearing is completed, hysterectomy remains the standard treatment.

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Section: Pregnancy Outcomes In Fertility-sparing Treatment Of Patientsupporting

confidence: 82%

Conservative management of young patients with endometrial highly-differentiated adenocarcinoma

Kalogiannidis

Αγοραστός

2011

Journal of Obstetrics and Gynaecology

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“…This low number of identified patients underlines the importance of focused patient counselling regarding fertility treatment options, as fertility problems following gonadotoxic treatment are not uncommon [ 1 , 2 ]. Current literature also only anecdotally report of patients who had undergone oocyte collection following cancer treatment, including case reports on successful live births—most commonly among women who had suffered from breast and gynaecological cancers [ 15 – 20 ]. Further reports include the births of a healthy infant from oocytes collected following intense cancer treatment (including HSCT) of a women with acute myeloid leukaemia [ 21 ] and of a child from oocytes successfully harvested from a patient following cranial tumour radiotherapy and chemotherapy [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Oocyte collection and outcome following oncologic treatment: a retrospective multicentre study

Fernández-González,

Borgmann-Staudt,

Llagostera

et al. 2024

Support Care Cancer

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Purpose This study assesses fertility treatment outcomes in female patients who had undergone successful oocyte retrieval following cancer therapy. Methods Between January 2020 and December 2022, we collected fertility treatment data from six participating centres in Spain and Germany. All patients associated with this data had undergone successful oocyte retrieval following cancer treatment. Results Women had most frequently been diagnosed with a haematological (41.9%), breast (22.6%) or gynaecological malignancy (12.9%); two thirds (67.7%) had previously received a chemotherapy, half a radiotherapy (53.3%) and 45.2% had undergone surgery. On average, 7 years (range 0–28) had passed between cancer treatment and first ovarian stimulation cycle. Forty-nine ovarian stimulation cycles had been conducted on these 31 women between 2004 and 2021 (mean age at first oocyte collection following treatment: 34.8 ± 5.7 years). On average, 7 oocytes were collected per cycle (range 0–26) and 11 were collected per patient (range 0–51). Out of the 190 oocytes collected for immediate use of artificial reproductive technique, 139 were fertilised at a rate of 73%. Live birth rate per fresh transfer was 45% (9/20); no births were reported following cryotransfer (0/10). Mean values of anti-Mullerian hormone (AMH) before stimulation declined with time since treatment; however, oocytes were successfully collected from four women with an AMH of <0.5 ng/ml, although no pregnancies were reported. Ten pregnancies were documented; 3 ended in miscarriage. Two twin and 5 single pregnancies resulted in nine live births. On average, children were carried to term. Conclusion In this small cohort, oocytes were successfully collected after chemotherapy and radiotherapy, despite—in individual cases—low AMH values. Further studies are needed to enrich the database and ultimately provide appropriate counselling to female cancer patients regarding expectations and ART outcome following cancer therapy.

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“…Thus conservative treatment of stage 1a and grade 1 endometrial adenocarcinoma is an available option in young women who wish to preserve their fertility. 16 According to the international literature, it appears that the most important factor for conservative treatment is selecting the "ideal patient" as given by Chiva L et al This is: 17 …”

Section: 13mentioning

confidence: 99%