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Successful Fertility Preservation in a Case of Low-Grade Endometrial Stromal Sarcoma: A Multidisciplinary Approach Through the Oncofertility Network.
Cureus
November 2024
Gynecologic Oncology, Hyogo College of Medicine, Nishinomiya, JPN.
Low-grade endometrial stromal sarcoma (LGESS) is a rare disease, accounting for less than 1% of all uterine malignancies. Standard treatment is total hysterectomy and bilateral tubal oophorectomy, although fertility preservation may be desirable because of the young age of onset. We document a case of fertility preservation in a 27-year-old nulligravida diagnosed with LGESS, which not only enabled the successful birth of two live infants but also underscores the efficacy of a multidisciplinary approach to patient treatment through the Hyogo Oncofertility Network (HOF-net).
View Article and Find Full Text PDFUpdate on the oncologic and obstetric outcomes of medroxyprogesterone acetate treatment for atypical endometrial hyperplasia and endometrial cancer.
J Obstet Gynaecol Res
September 2024
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Article Synopsis
- A study evaluated the safety and effectiveness of high-dose oral medroxyprogesterone acetate (MPA) as a fertility-sparing treatment for patients with atypical endometrial hyperplasia (AEH) and grade 1 endometrial carcinoma (G1EC).
- Researchers analyzed data from 79 patients treated at Nagoya University Hospital from 2005 to 2024, focusing on treatment outcomes and recurrence factors.
- Results showed a high complete response (CR) rate of 91.1%, with many patients achieving CR after extended treatment, and significant success in subsequent pregnancies after treatment.
A phase II trial evaluating the efficacy and safety of repeated high dose medroxyprogesterone acetate (MPA) therapy for patients with recurrent early-stage endometrial cancer or atypical endometrial hyperplasia: Japanese Gynecologic Oncology Group study (JGOG2051/KGOG2031, REMPA trial).
J Gynecol Oncol
November 2024
Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan.
Background: Fertility preserving therapy using medroxyprogesterone acetate (MPA) is an important option for young patients with endometrial cancer or atypical endometrial hyperplasia (AEH). However, the effectiveness and feasibility of repeated MPA therapy for patients with intrauterine recurrence following initial MPA therapy is controversial. Only a few single-institution retrospective studies have been conducted on repeated MPA therapy, therefore, multicenter prospective studies for repeated MPA therapy are highly needed.
View Article and Find Full Text PDFMedical Management of Endometriosis in Adolescent and Young Adult Women: A Review of 91 Cases of Biopsy-Confirmed Endometriosis.
J Obstet Gynaecol Can
July 2024
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA. Electronic address:
Objectives: To characterise contemporary trends in the hormonal management of endometriosis in adolescent and young adult patients with biopsy-proven endometriosis.
Methods: Retrospective chart review of women aged 14-25 years who underwent laparoscopy for pelvic pain with biopsy-proven endometriosis between January 2011 and September 2020 at an academic tertiary hospital system. The final sample included 91 patients with biopsy-confirmed endometriosis.
Original delayed-start ovarian stimulation protocol with a gonadotropin-releasing hormone antagonist, medroxyprogesterone acetate, and high-dose gonadotropin for poor responders and patients with poor-quality embryos.
Front Endocrinol (Lausanne)
December 2023
Takeuchi Ladies Clinic/Center for Reproductive Medicine, Kagoshima, Japan.
Introduction: The delayed-start gonadotropin-releasing hormone antagonist protocol seems effective for patients who are poor ovarian responders, but there are insufficient data on whether it is also effective for patients with poor-quality embryos and low rates of good blastocyst formation. Specifically, the effectiveness of delayed-start gonadotropin-releasing hormone antagonists with progesterone has not been adequately investigated. Therefore, we compared the efficacy of the original delayed-start gonadotropin-releasing hormone antagonist protocol using medroxyprogesterone acetate (MPA) and high-dose gonadotropin in patients with poor ovarian response.
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