Abstract:
The purpose of this study was to determine whether utilization of assisted reproductive technology following clearance of endometrial intraepithelial neoplasia (EIN) or early endometrial cancer (EC) shortens time to conception (TTC) and reduces recurrence. Patients aged 18 to 45 with EIN or early EC who achieved pathologic response following progesterone treatment were identified via retrospective chart review. Study groups included patients who pursued ovulation induction (OI), in vitro fertilization (IVF), and spontaneous pregnancy. Primary outcomes were TTC and recurrence rate. Three hundred forty-six charts were reviewed, with 86 patients meeting inclusion criteria and 53 attempting pregnancy. Of those 53 patients, 11 became pregnant and seven had a live birth. Median times to pregnancy were 183 days for IVF, 54 days for OI, and 347 days for spontaneous conception (p < 0.05). No differences were seen in recurrence or progression based on attempted pregnancy method, nor with duration of fertility treatment. Forty-two of 86 patients (49%) were lost to follow-up. For patients with a history of treated EIN or EC, OI may decrease TTC. Larger prospective studies are needed to definitively answer this question. Although no differences in recurrence or progression were identified, the significant loss to follow-up rate in this study is concerning and warrants further investigation.
摘要:
这项研究的目的是确定清除子宫内膜上皮内瘤变(EIN)或早期子宫内膜癌(EC)后使用辅助生殖技术是否可以缩短受孕时间(TTC)并减少复发。通过回顾性图表审查,确定了18至45岁的EIN或早期EC患者在孕酮治疗后获得病理反应。研究组包括进行排卵诱导(OI)的患者,体外受精(IVF),和自发怀孕。主要结果是TTC和复发率。审查了346张图表,86例患者符合纳入标准,53例尝试怀孕。在这53名患者中,11人怀孕,7人活产。试管婴儿的平均怀孕时间为183天,OI的54天,自发受孕347天(p<0.05)。根据尝试的妊娠方法,在复发或进展方面没有发现差异,也没有生育治疗的持续时间。86例患者中有42例(49%)失访。对于有EIN或EC治疗史的患者,OI可以降低TTC。需要更大的前瞻性研究来明确回答这个问题。尽管没有发现复发或进展的差异,本研究中随访率的显著下降令人担忧,值得进一步调查.