Fertility Preservation in Early-Stage Endometrial Carcinoma and EIN: A Single-Centre Experience and Literature Review

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Simple SummaryEndometrial cancer is the most common gynaecological malignancy in developed countries, with rising incidence and mortality. In reproductive-age women diagnosed with early-stage disease or endometrial intraepithelial neoplasia, fertility-sparing treatment may be a viable option. This retrospective study evaluated 13 patients treated at the University of Debrecen between 2018 and 2023. The majority of patients responded well to therapy, and several pregnancies were able to be achieved. These findings support the feasibility of conservative management in selected cases, emphasising the importance of a multidisciplinary approach.Objectives: Endometrial carcinoma is the most common gynaecological cancer in developed countries, with both incidence and mortality rates continuing to rise globally. For women of reproductive age diagnosed with early-stage disease or endometrial intraepithelial neoplasia, fertility-preserving treatment should be considered to maintain the possibility of future childbearing. Effective fertility-sparing management requires a multidisciplinary approach that includes patient education, reduction in risk factors, accurate molecular and histological classification to guide targeted therapies, assisted reproductive technologies to improve early conception rates, and attention to the psycho-sexual well-being of patients to support treatment adherence. Methods: This retrospective cohort study analysed the clinicopathological features and treatment outcomes of thirteen patients who received fertility-preserving therapy between 2018 and 2023. Results: The mean age of the patients (n = 13) was 34.4 years, with a range of 20 to 41 years. The overall treatment response rate was 76.9%, including 69.2% complete and 7.7% partial responses. Stable disease was observed in 15.4% of cases, while progression occurred in 7.7%. Among those who achieved complete remission, in vitro fertilisation (IVF) was initiated in four cases, with two ongoing as of the time of data analysis. In one of the cases, after two unsuccessful assisted reproductive attempts, spontaneous conception occurred, resulting in the birth of a child. Conclusions: Our findings support the feasibility and success of fertility-preserving treatment in carefully selected patients, allowing the preservation of reproductive potential alongside oncological care.