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Published on: January 22, 2022
Successful in vitro fertilization pregnancy after conservative management of endometrial cancer
A B Pinto1, M Gopal, T J Herzog
1Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63108, USA.
Objective:
To report a successful IVF pregnancy in an infertile couple after conservative treatment of endometrial cancer.
Design:
Case report and literature review.
Setting:
University teaching hospital.
Patient(S):
A 29-year-old infertile white woman.
Main Outcome Measure(S):
Successful pregnancy after conservative management of endometrial cancer.
Intervention(S):
Grade 1 endometrial adenocarcinoma diagnosed at hysteroscopy, followed by dilatation and curettage (D&C). On follow-up D&C, pathologic examination was normal after high-dose progesterone therapy. The patient subsequently underwent an IVF cycle with transfer of three blastocysts.
Result(S):
The patient delivered triplets by cesarean section. Laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy was then done. No residual endometrial cancer was evident in the hysterectomy specimen, but a 1.1-cm cystic mixed endometrioid and clear cell-type adenocarcinoma was discovered in the left ovary. The patient is doing well after 3 cycles of chemotherapy; her CA-125 level is normal. The triplets are also doing well.
Conclusion(S):
In carefully chosen situations, deferring surgery in infertile patients with endometrial cancer may be a viable option permitting subsequent successful pregnancy.
