Study on the Combination of Levonorgestre-Releasing Intrauterine System and Metformin for the Preservation of Fertility in the Treatment of Atypical Endom-etrial Hyperplasia and Early Endometrial Cancer
Objective:To investigate the therapeutic effectiveness and related factors of fertility preservation therapy(referred to as conservation therapy)using Levonorgestre-releasing intrauterine system(LNG-IUS)com-bined with Metformin in patients with atypical endometrial hyperplasia and early endometrial cancer.Methods:A retrospective analysis was conducted on the clinical data of 41 patients with atypical endometrial hyperplasia and 11 patients with early endometrial cancer who required fertility preservation therapy and admitted to Shenyang Women and Children's Hospital from January 1,2015 to December 30,2021.According to different treatment methods,they were divided into a study group(26 cases,LNG-IUS+metformin)and a control group(26 cases,high efficiency progesterone+metformin).Regularly review endometrial pathology and analyze the differences in complete remission rate,recurrence rate,and pregnancy outcomes between the two groups.Univariate Logistic regression was used to analyze the factors affecting complete remission,recurrence,and pregnancy outcomes in those patients.Results:There was no statistically significant difference in general clinical data between the two groups(P＞0.05).Compared with the control group,the study group had higher complete remission rate,shorter average complete remission time,less recurrence rate,and higher live birth rate,with a statistically significant be-tween the two groups(P＜0.05).Logistic regression analysis found that body mass index(BMI)≥30 kg/m2was a risk factor for complete remission(P＜0.05);BMI ≥30 kg/m2 and patients with diabetes or insulin resistance were the risk factors for recurrence after treatment(P＜0.05);BMI≥30 kg/m2 and diseases associated with fe-male reproductive system were the risk factors for pregnancy after preserving fertility therapy(P＜0.05).Conclu-sions:LNG-IUS combined with metformin has a more satisfactory therapeutic effect and pregnancy outcomes,compared to high efficiency progesterone combined with metformin in preserving fertility therapy.At the same time,BMI＜30 kg/m2 can increase the complete remission rate,reduce the recurrence rate after cure,and in-crease the pregnancy rate after preserving fertility therapy.
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