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#1066 Fertility sparing treatment with levonorgestrel intrauterine device for in atypical hyperplasia of the endometrium in young women
  1. Ons Kaabia and
  2. Rim Bouchahda
  1. Université de Sousse, Faculté de M2deciend e Sousse, Service de gynécologie obstétrique, CHU Farhat hached, Sousse, Tunisia


Introduction/Background Due to generalization of hysteroscopy, the diagnosis of Atypical hyperplasia of the endometrium in young patients with a fertility preservation wich is a delicate situation for the clinitian and for the patient. We aim to assess the endometrial response rates to treatment with the levonorgestrel intrauterine device (LNG-IUD) in in young women with atypical hyperplasia/endometrial intraepithelial neoplasia endometrial carcinoma who wished to preserve their fertility.

Methodology A prospective monocentric study was conducted from January 2016 to January 2023. Patients under 41 years old with AH were treated with LNG-IUD after complete macroscopic hysteroscopic resection. The histologic change of the endometrial tissue was assessed by both vaginal ultrasound and hysteroscopy with curettage every 3 months. The regression rate was calculated at 6 months of treatment.

Results The study recruited 29 patients. One withdrew because she was pregnant at the time of IUD insertion and 9 did not show during the follow up. Among the 19 patients with sufficient follow up to assess response, 9 had a documented complete response (CR), 5 no response, 4 progressed. Among the patients that had initially a complete response, 2 got pregnant (1 spontaneous miscarriage and 1 premature delivery) and 2 experienced relapse of hyperplasia or cancer after 2 years of follow up.

Conclusion The need for a fertility spearing treatment to AH in young women is real but not so frequent in our daily practice. LNG-IUD treatment in addition to complete macroscopic hysteroscopic resection for AH showed 50% of CR rate at 6 months but relapses were observed after a 2 year follow up.

Disclosures Nothing to disclose

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