Fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer patients: oncological and reproductive results

Objective. To evaluate and to compare oncological and reproductive results of hormonal therapy in young women with atypical endometrial hyperplasia (AEH) and early endometrial cancer (EC) according to experience of N.N. Blokhin NMRCO. Methods. Retrospective trial of 84 reproductive age women with AEH and EC (endometrioid grade 1 adenocarcinoma) without myometrial invasion fertility-sparing treated in oncogynecological department of N.N. Blokhin NMRCO from may 2020 to october 2025. EC patients were treated with combination of levonorgestrel intrauterine device (IUD) and gonadotropin-releasing hormone agonist (GnRH). AEH patients were treated with levonorgestrel IUD only. Results. Total of 84 patient were analyzed, AEH (n=26) and EC (n=58). Complete response rate was 100% in AEH and 94.8% in EC. There were no recurrences in AEH group with median follow-up 27.3 (5—47) months. The recurrence rate in EC group was 7.4% with median follow-up 24.5 (1—58) months. The overall conception rate was 21.4%, among them 55.6% with assistant reproductive technologies use. Of total 84 patients 12 (14.3%) delivered successfully. Conclusion. Hormonotherapy of AEH and EC is effective and safe method of fertility-sparing treatment with high probability of conception and delivery.