Application of progesterone in preserving fertility in endometrial cancer and atypical endometrial hyperplasia
The onset of endometrial cancer and atypical endometrial hyperplasia is gradually becoming younger,and the current childbearing age is generally delayed,which makes these patients have a great demand for fertility sparing treatment.As the second most common gynecological malignancy in China,the standard treatment is total hysterectomy and bilateral adnexectomy,which leads to permanent infertility.Progesterone is effective in the treatment of early-stage endometrial cancer and atypical endometrial hyperplasia without destroying fertility.Screening criteria for these patients have been recommended in guidelines.Oral megestrol acetate and medroxyprogesterone acetate are the most commonly used fertility sparing treatments,levonorgestrel-releasing intrauterine devices,as a local progesterone therapy,can not be ignored.In addition,studies on the combination of progesterone drugs with metformin and gonadotropin releasing hormone agonist are being carried out.Facing the limitations of existing treatment options,it is equally important to actively search for therapeutic and prognostic markers,and explore new treatment methods.
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