Article Text
Abstract
Objectives The aim of this paper is to present a case of an IVF pregnancy of a 43-year old women being treated for recurrent endometrial cancer stage IA, grade I.
Methods Our patient was initially treated five years ago when hysteroscopic ablation of endometrial polyp was performed. Pathologic examination of biopsy specimen reported a diagnosis of atypical polypoid adenomyoma. Two years later, patient was evaluated for recurrent local disease. At that time, pathologic examination revealed typical polypoid adenomyoma with presence of few glands with characteristics of well differentiated endometrioid adenocarcinoma stage IA, grade I.
Results After a complete evaluation of cancer staging and a detailed explanation, patient rejected conventional surgical treatment and fertility preserving treatment was started. Progestin therapy via an intrauterine device (IUD) was administered. One year later, IUD was removed and patient underwent IVF cycle with a transfer of 3 embryos without success. At the age of 43, pregnancy was achieved in IVF cycle with administration of hCG.
Conclusions Although there are existing evidence of effectiveness for using IUD progestin therapy in endometrial hyperplasia, studies for its use in treatment of endometrial cancer are lacking. We report a case of successful use of leveonorgestrel - IUD alone in fertility preserving treatment followed by achieved pregnancy.