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AS14. Pre-invasive disease
PR078/#804  A multicentre randomised contolled trial on the outcomes of fertility sparing treatment of atypical endometrial hyperplasia
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  1. Charissa Goh1,
  2. Joella Ang2,
  3. Michelle Jia Min Loh1,
  4. Whui Whui Lim2,
  5. Pearl Tong3,
  6. Ravichandran Nadarajah2,
  7. Tze Tein Yong2,
  8. Yen Ching Yeo4 and
  9. Jessie Phoon1
  1. 1KK Women’s and Children’s Hospital, Department of Reproductive Medicine, Singapore, Singapore
  2. 2Singapore General Hospital, Department of Obstetrics and Gynaecology, Singapore, Singapore
  3. 3National University Hospital, Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Singapore, Singapore
  4. 4KK Women’s and Children’s Hospital, Department of Pathology and Laboratory Medicine, Singapore, Singapore

Abstract

Introduction Mirena and/or megestrol acetate (megace) are often used as medical treatment for atypical endometrial hyperplasia (AH) in women who are keen to preserved fertility. However, to-date, there has been no RCTs evaluating the performance of Mirena with megace in the treatment of AH.

Methods The study team conducted a multi-centre randomised controlled trial (RCT) on the use of Mirena compared to megace in the treatment of AH from January 2020 to the January 2023. Women aged 40 years old and below were included and randomised to receive either Mirena or megace. The patients underwent an endometrial biopsy every 3 months for a maximum treatment duration of 9 months. The primary outcome assessed was the regression rate. The secondary outcomes assessed include side effects, patient acceptability and fertility outcomes.

Results The RCT recruited 34 patients among 3 centres in Singapore. The mean age was 32.2 years and the mean BMI was 36.2 (range: 20 – 55.9). There were 31 patients who completed the study. The overall regression rate was 87.1% by 9 months with no significant difference between the two arms. There was no significant difference in side effects and weight change in both arms.

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Abstract PR078/#804 Table 1
Abstract PR078/#804 Figure 1
Abstract PR078/#804 Figure 1

Conclusion/Implications Our study confirms a high regression rate of AH with medical treatment. Mirena is a non-inferior treatment compared to megestrol acetate.

https://doi.org/10.1136/ijgc-2023-IGCS.117

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