medigraphic.com

2018, Number 2

<< Back

Rev Mex Med Repro 2018; 8.9 (2)

Clinical case report treated with menotropins (Merapur®): endometrial cancer and pregnancy

Pérez-Álvarez RME, Campos-Cañas JA, Cruz-Orozco OP, Soriano- Jiménez JD

Language: Spanish
References: 16
Page: 38-46
PDF size: 316.63 Kb.


Text Extraction

Approximately 5% of endometrial cancers are diagnosed in young women under the age of 40 years. If detected early, conservative management can treat endometrial cancer with good results and low recurrence rate in women with unfulfilled wishes to conceive. This paper reports the case of 29-year-old woman who was referred in 2012 for having endometroid endometrial adenocarcinoma stage I and wishing pregnancy in the short term. The patient was managed with progestins, achieving remission of endometrial cancer. She underwent in vitro fertilization (IVF) in 2014. The antagonist protocol was prescribed with rFSH, obtaining three follicles ≥ 18 mm and 12 retrieved oocytes on trigger day. Among the oocytes, 50% where mature and half were fertilized, corresponding to 25% of total oocytes retrieved. Two embryos were transferred, but pregnancy was not achieved. In the second IVF cycle in 2015, menotropins were added to rFSH in a long agonist protocol. Six follicles ≥ 18 mm and 14 oocytes were obtained on trigger day. Among the oocytes retrieved, 92.8% were mature and 84.6% were fertilized, representing 78.5% of total oocytes retrieved. Three embryos were transferred, achieving triplet pregnancy and three live births at home.


REFERENCES

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016;66:7-30.

  2. Kalogera E, Dowdy SC, Bakkum-Gamez JN. Preserving fertility in young patients with endometrial cancer: current perspectives. Int J Women’s Health 2014;6:691.

  3. Zivanovic O, Carter J, Kauff ND, Barakat RR. A review of the challenges faced in the conservative treatment of young women with endometrial carcinoma and risk of ovarian cancer. Gynecol Oncology 2009;115(3):504-509.

  4. Diagnóstico y tratamiento de la anovulación. Ginecol Obstet Mex 2011;79(11):683-696.

  5. Carneiro MM, Lamaita RM, Ferreira MCF, Silva-Filho AL. Fertility-preservation in endometrial cancer: is it safe? Review of the literature. JBRA Assisted Reproduction 2016;20(4):232.

  6. Ambe AK, Ortiz CSL y col. Consenso nacional Mexicano de reproducción asistida. Ginecol Obstet Mex 2012;80(9):581- 624.

  7. Dehesa MF, Gómez ACA, Verduzco EM, Aranda CE. Embarazo después del tratamiento conservador de cáncer de endometrio. Ginecol Obstet Mex 2009;77(9):419-22.

  8. Feichtinger M, & Rodriguez-Wallberg KA. Fertility preservation in women with cervical, endometrial or ovarian cancers. Gynecol Oncol Res Practice 2016;3(1):8.

  9. Park JY, Nam JH. Progestins in the fertility-sparing treatment and retreatment of patients with primary and recurrent endometrial cancer. The oncologist 2015;20(3):270-278.

  10. Simpson AN, Feigenberg T, et al. Fertility sparing treatment of complex atypical hyperplasia and low-grade endometrial cancer using oral progestin. Gynecol Oncol 2014;133(2):229-233.

  11. Park JY, Seong SJ, et al. Pregnancy outcomes after fertilitysparing management in young women with early endometrial cancer. Obstet Gynecol 2013;121(1):136-142.

  12. Arteaga-Gómez AC, Castellanos-Barroso G, Márquez- Acosta G. Tratamiento conservador del cáncer de endometrio como una opción para preservar la fertilidad. Experiencia de cinco años en el Instituto Nacional de Perinatología Isidro Espinosa de los Reyes. Ginecol Obstet Mex 2012;80(6):394-399.

  13. Fujimoto A, et al. The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer. J Assist Reprod Gen 2014;31(9):1189.

  14. Gungor T, Cetinkaya N, Yalcin H, et al. Clinicopathologic characteristics and treatment features of women with the incidental diagnosis of endometrial adenocarcinoma during infertility follow-up in Ankara, Turkey. Taiwan J Obstet Gynecol 2016;55(3):309-313.

  15. Park JY, et al. Long-term oncologic outcomes after fertility- sparing management using oral progestin for young women with endometrial cancer (KGOG 2002). Eur J Cancer 2013;49(4):868-874.

  16. Al-Inany HG, et al. Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a metaanalysis. Reprod Biomed Online 2008;16(1):81-88.




2020     |     www.medigraphic.com