Introduction/Background The purpose of the present study is to evaluate the efficacy of the combination of low dose megestrol acetate (MA) (80 mg/day) and the levonorgestrel-releasing intrauterine device (LNG-IUD) for the treatment of complex atypical hyperplasia (CAH) and low-grade endometrial adenocarcinoma (EC) in premenopausal women, 45 years old or younger, who desire to preserve their fertility.

Methodology A retrospective study that included a consecutive series of patients of reproductive age who were treated conservatively with the combination of per os MA (80 mg/day) and the LNG-IUD for CAH and grade I endometrioid EC. The response rate for each of the two conditions was monitored following a 6-month period of treatment.

Results Twenty-two patients were diagnosed with CAH or grade I endometrioid EC. Eighteen of them were evaluable at the 6-month study point. Among them, 5 patients (27.8%) had an initial diagnosis of CAH and the other 13 (72.2%) were diagnosed with grade I endometrioid EC. Overall, the response rate was 77.7% at the 6-month evaluation exam (80% for the CAH group and 76.9% for the grade I endometrioid EC).

Conclusion The concomitant use of low-dose MA orally and the LNG-IUD seems to be an efficient option for the conservative treatment of CAH or early- grade EC in young women who wish to preserve their fertility. Future studies should provide head to head comparison with systemic progestin therapy to corroborate our findings.

Disclosure Nothing to disclose.