Outcomes of in vitro fertilization cycles following fertility-sparing treatment in stage IA endometrial cancer

Abstract

This study aimed to present cases involving in vitro fertilization (IVF) cycles in patients with stage IA endometrial adenocarcinoma (EC) who underwent fertility-sparing conservative treatment. Twenty-two patients who underwent IVF cycles in a single fertility center between May 2005 and February 2017 after progestin treatment for stage IA EC were chosen for this study. Outcomes of IVF cycles were analyzed retrospectively. Women of a median age of 34years (range 26-41years) underwent a total of 49 embryo transfers within an average of 2months after their last progestin treatment. The clinical pregnancy rate per transfer was 26.5%, implantation rate was 16.7%, and live birth rate was 14.3%. The cumulative clinical pregnancy rate was 50% (11/22), resulting in 6 live births (27.3%) within 3 cycles of embryo transfer. The median endometrial thickness on the day of human chorionic gonadotropin injection in 34 fresh cycles was 9.0mm (range 4-10mm) in live births, 7.5mm (range 6-9mm) in miscarriages, and 6.0mm (range 4-15mm) in no pregnancy cases. During a median post-cancer treatment follow-up period of 41months (range9-150months), 6 (27.3%) women underwent definitive hysterectomy for EC relapse. This study showed an acceptable cumulative pregnancy rate after the IVF procedure in patients with early-stage EC who were treated conservatively. Considering the high relapse rate, it is of great importance that these patients are closely monitored after the IVF cycles.