The analysis of reproductive outcomes and recurrence of patients undergoing in vitro fertilization-embryo transfer after fertility-sparing treatment for atypical endometrial hyperplasia and endomtrial cancer
Objective:To summarize the clinical characteristics and prognosis of patients undergoing in vitro fertilization-embryo transfer(IVF-ET)after fertility-sparing treatment for atypical endometrial hyperplasia and early endometrial cancer(AH/EEC),and to analyze the main factors for reproductive outcomes and disease recurrence.Methods:A retrospective analysis was performed for the clinical data of patients who received assisted reproductive technology(ART)treatment after AH/EEC fertility-sparing treatment in Peking Union Medical College Hospital from February 2012 to February 2022.Clinical features,indicators related to IVF-ET,reproductive outcomes and recurrence were summarized.Risk factors for clinical pregnancy and live birth rates as well as recurrence rates were evaluated with univariate and multivariate analyses.Results:A total of 78 patients recruited in the study.There are 51(65.38％)AH patients and 27(34.62％)EEC ones.The average age at the initiation of an IVF-ET cycle was 34.17±3.70 years.A total of 74 patients received at least one time of embryo transfer.The clinical pregnancy rate and live birth rate per ET were 36.31％(65/179)and 18.99％(34/179),respectively,and the cumulative pregnancy rate was 72.97％(54/74).Multivariate analysis suggests that the initial onset age of AH/EEC was the independent risk factor for live birth rate[OR=0.879 4,95％CI(0.785,0.983),P=0.02].The overall recurrence rate of AH/EEC in IVF-ET cycle was 6.41％(5/78).Both the pathological type of endometrial lesions and the history of recurrence before IVF-ET were significantly correlated with the recurrence of disease(P＜0.05).Conclusions:The reproduction outcomes after fertility-sparing treatment are relatively satisfied.Attention should be paid to protecting the endometrium and reducing damage during evaluation of the endometrial lesion.Fertility treatment should be given as soon as possible after the oncology treatment to minimize the recurrence rate.
万方数据
维普
