Embryo cryopreservation after diagnosis of stage IIB endometrial cancer and subsequent pregnancy in a gestational carrier

Juretzka, Margrit M.; O’Hanlan, Katherine A.; Katz, Steven L.; El-Danasouri, Imam; Westphal, Lynn M.

doi:10.1016/j.fertnstert.2004.09.026

Cited by 20 publications

(9 citation statements)

References 9 publications

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“…62 A recent case report used this approach for a 39-year-old patient with a grade II/III endometrial adenocarcinoma, who strongly desired fertility. 98 After diagnosis, the patient received a progesterone IUD, ovarian stimulation with gonadotropins, egg retrieval, and embryo cryopreservation. Sixteen days after egg retrieval, the patient underwent a laparoscopic-assisted vaginal hysterectomy, and BSO.…”

Section: Fertility Optionsmentioning

confidence: 99%

Fertility-Sparing Management of Endometrial Adenocarcinoma

Dorais

Dodson

Calvert

et al. 2011

Obstetrical &Amp; Gynecological Survey

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Obstetricians & Gynecologists, Family Physicians Learning Objectives: After participating in this activity, physicians should be better able to select appropriate candidates with endometrial cancer for fertility-sparing treatment. Educate patients with endometrial cancer regarding the risks and benefits of standard of care therapy and conservative therapy and screen appropriate patients for Lynch syndrome.

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Section: Fertility Optionsmentioning

confidence: 99%

Fertility-Sparing Management of Endometrial Adenocarcinoma

Dorais

Dodson

Calvert

et al. 2011

Obstetrical &Amp; Gynecological Survey

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“…In earlier studies where assisted reproductive technologies were used in cases with existing endometrial cancer, typically the endometrium was ''normalized'' with high-dose progestin treatment before attempting IVF with conventional stimulation protocols (10)(11)(12)(13)(14)(15)(16)(17)(18)(19) (Table 3). Those stimulation regimens generally expose patients to high estrogen levels, and, with the exception of a case by Juretzka et al (19) where a progestin-impregnated intrauterine device was inserted during stimulation, no attempt was made to protect the endometrium against the effects of estrogen.…”

Section: Discussionmentioning

confidence: 99%

“…Those stimulation regimens generally expose patients to high estrogen levels, and, with the exception of a case by Juretzka et al (19) where a progestin-impregnated intrauterine device was inserted during stimulation, no attempt was made to protect the endometrium against the effects of estrogen.…”

Section: Discussionmentioning

confidence: 99%

“…Because clinical staging can underestimate the extent of the disease in about 20% of stage I endometrial carcinoma (20) the delay or omission in surgical staging can be detrimental (19). For example, in a series of eight patients where progestagen treatment failed, one had recurrence in the preserved ovary and ultimately succumbed to her disease (2).…”

Section: Discussionmentioning

confidence: 99%

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Letrozole for ovulation induction and fertility preservation by embryo cryopreservation in young women with endometrial carcinoma

Azim

Oktay

2007

Fertility and Sterility

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“…Collectively, there is growing evidence supporting the safety and feasibility of ART in young EC patients following successful fertility-sparing treatment 64,68,99,100. In an effort to decrease the effects of estrogen exposure to the endometrium, Juretzka et al101 used a PG-IUD during ovarian stimulation. Toward this direction, Azim and Oktay102 suggested in 2007 an ovarian stimulation protocol based on the use of letrozole, an aromatase inhibitor, in conjunction with gonadotropins, which was associated with lower estrogen levels compared with standard stimulation cycles as well as good reproductive outcomes.…”

Section: Hormone Treatmentmentioning

confidence: 99%

Preserving fertility in young patients with endometrial cancer: current perspectives

Kalogera

Dowdy

Bakkum-Gamez

2014

IJWH

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Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries and affects predominantly postmenopausal women. It is estimated, however, that 15%–25% of women will be diagnosed before menopause. As more women choose to defer childbearing until later in life, the feasibility and safety of fertility-sparing EC management have been increasingly studied. Definitive treatment of total hysterectomy and bilateral salpingo-oophorectomy precludes future fertility and may thus be undesirable by women who wish to maintain their reproductive potential. However, the consideration of conservative management carries the oncologic risks of unstaged EC and the risk of missing a synchronous ovarian cancer. It is further complicated by the lack of consensus regarding the initial assessment, treatment, and surveillance. Conservative treatment with progestins has been shown to be a feasible and safe fertility-sparing approach for women with low grade, early stage EC with no myometrial invasion. The two most commonly adopted regimens are medroxyprogesterone acetate at 500–600 mg daily and megestrol acetate at 160 mg daily for a minimum of 6–9 months, with initial response rates commonly reported between 60% and 80% and recurrence rates between 25% and 40%. Photodynamic therapy and hysteroscopic EC excision have recently been reported as alternative approaches to progestin therapy alone. However, limited efficacy and safety data exist. Live birth rates after progestin therapy have typically been reported around 30%; however, when focusing only on those who do pursue fertility after successful treatment, the live birth rates were found to be higher than 60%. Assisted reproductive technology has been associated with a higher live birth rate compared with spontaneous conception, most likely reflecting the presence of infertility at baseline. Close follow-up is of paramount importance, and definitive treatment after completion of childbearing is advised.

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Embryo cryopreservation after diagnosis of stage IIB endometrial cancer and subsequent pregnancy in a gestational carrier

Cited by 20 publications

References 9 publications

Fertility-Sparing Management of Endometrial Adenocarcinoma

Fertility-Sparing Management of Endometrial Adenocarcinoma

Letrozole for ovulation induction and fertility preservation by embryo cryopreservation in young women with endometrial carcinoma

Preserving fertility in young patients with endometrial cancer: current perspectives

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