Realization of reproductive potential in patients with atypical hyperplasia and stage I endometrial cancer


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Abstract

Aim To determine the most effective way of getting pregnant for patients with a history of initial stages of endometrial cancer. Materials and methods The study comprised 77 patients of reproductive age who were seeking to conceive after achieving remission or required retrieval and cryopreservation of reproductive material before starting cancer treatment. The study participants were divided into groups classified by the presence of stage I endometrial cancer (group 1, n=48) and atypical endometrial hyperplasia (group 2, n=29). Results Seventeen (35.4%) and 6 (20.7%) women in groups 1 and 2, respectively, had polycystic ovary syndrome with severe endocrine and metabolic dysfunctions. There was a lack of unified approaches to counseling and management of this category of patients, which was associated with a high recurrence rate. Procurement of reproductive material after treatment of the present disease resulted in a limited number and poor quality of oocytes/embryos. This observation implied the need for retrieval and cryopreservation of reproductive material before starting treatment. A low pregnancy rate of 21.7% per attempt was probably associated with impaired embryo implantation and endometrial receptivity following exposure to the levonorgestrel intrauterine system. Conclusion The pregnancy rate after 69IVF attempts was 21.7% (15pregnancies). The low pregnancy rate and the questions encountered during the treatment suggest the need for further studies.

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About the authors

L. G Dzhanashvili

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: lana.janashvili@gmail.com
Ph.D. Student 117997 Russia, Moscow, Ac. Oparina str. 4

T. A Nazarenko

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: t.nazarenko@mail.ru
Dr.Med.Sci., Professor, Head of the Institute of Reproductive Medicine 117997 Russia, Moscow, Ac. Oparina str. 4

O. S Balakhontseva

Zdanovsky Clinic

Email: osbal2383@gmail.com
Ph.D. at the Professor

Y. A.O Martirosyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia; I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: marti-yana@yandex.ru
Clinical Resident at the Department of Obstetrics, Gynecology, Perinatology and Reproductive Medicine of the Medical Faculty 117997 Russia, Moscow, Ac. Oparina str. 4

S. M Pronin

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: s_pronin@oparina4.ru
Ph.D., Senior Researcher at the Department of Innovative Oncology and Gynecology 117997, Russia, Moscow Ac. Oparina Street 4. Tel.: 8(495)5314444

E. A Kalinina

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: e_kalinina@oparina4.ru
Dr.Med.Sci., Professor, Head of B.V. Leonov Department of Assisted Technologies in Infertility 17997, Russia, Moscow Ac. Oparina Street 4

A. M Biryukova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia

Email: alma21@list.ru
Ph.D., Clinical Care Supervisor at the F. Paulsen Research and Educational Center for ART with the Clinical Department 117997 Russia, Moscow, Ac. Oparina str. 4

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