PT  - JOURNAL ARTICLE
AU  - Papakonstantinou, Aikaterini
AU  - Panagakis, George
AU  - Liakakos, Theodoros
AU  - Sotirchos, Athanasios
AU  - Papageorgiou, Dimitris
AU  - Karaiskou, Akrivi
AU  - Theofanakis, Charalampos
AU  - Petrogiannis, Nikolaos
AU  - Trachanas, Dimitrios
TI  - #678 Fertility sparing treatment in women with complex atypical endometrial hyperplasia-our clinical experience
AID  - 10.1136/ijgc-2023-ESGO.364
DP  - 2023 Sep 01
TA  - International Journal of Gynecologic Cancer
PG  - A177--A177
VI  - 33
IP  - Suppl 3
4099  - http://ijgc.bmj.com/content/33/Suppl_3/A177.1.short
4100  - http://ijgc.bmj.com/content/33/Suppl_3/A177.1.full
SO  - Int J Gynecol Cancer2023 Sep 01; 33
AB  - Introduction/Background Complex atypical endometrial hyperplasia suggests a pre-malignant state of endometrial cancer which tends to occur in women of reproductive age. Oral progestins have been used as conservative treatment in young women with atypical endometrial hyperplasia who want to preserve their fertility. This treatment can be used alone or combined with Levonorgestrel-releasing intrauterine system (Mirena). LNG-IUD could be also used alone. The aim of our study was to evaluate the response of treatment in women who received oral progestins as monotherapy and others who were treated with LNG-IUD.Methodology We conducted a randomized prospective study, at the gynecological department of the Naval Hospital of Athens since 2019. We included women, 32–38 years old, with complex atypical endometrial hyperplasia, treated with oral progestins alone, compared to Levonorgestrel-releasing intrauterine device. The histology of the patients was reevaluated every 6 months by hysteroscopy and curettage.Results So far, 12 women wishing to preserve fertility, have been included in the study. Five patients received oral progestins alone and 4 out of 5 achieved disease regression. Five patients were treated only with LNG-IUD and are free of disease. Two quite obese patients were treated with a combination of LNG-IUD and oral progestins and are also free of disease.Conclusion Although a larger sample is needed, the preliminary results are encouraging. Both oral progestins and LNG-IUD are effective in women who undergo fertility sparing treatment. Megestrol acetate had higher and quicker remission rates than medroxyprogesterone acetate. Regarding disease regression, the LNG-IUD proved to be more effective. Furthermore, there were no side effects associated with the use of LNG-IUD, whereas one woman who received megestrol acetate experienced secondary adrenal insufficiency. After complete response, conception should be recommended. Maintenance therapy with strict follow-up can also be proposed to decrease recurrence, along with proper counseling over the safety of this approach.Disclosures No conflict of interest