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The reproductive prognosis of women considering fertility preservation for early stage endometrial cancer

  • Pietro Gambadauro
Correspondence
  • 19 Downloads

Dear Editors,

The recent survey by La Russa et al. [1], despite low participation, gives an interesting overview of the attitude of European gynaecological oncologists towards conservative management of early endometrial cancer (CM) in young women. The study is very timely and, although it cannot scientifically legitimate the routine use of CM more than what is already known, it suggests that oncologists are concerned with the fertility wish of women with early endometrial cancer.

The findings of the survey give insights about what would be recommended (i.e., medical/surgical treatment and referral to assisted reproduction), though less is unfortunately revealed about who would eventually be offered CM. Statistics about pregnancy rates after CM by progestins, with or without hysteroscopic resection, largely ground on observational retrospective data [2], hence care should be adopted when interpreting and extrapolating published success rate figures. Therefore, clinicians may need to...

Keywords

Assisted reproductive technologies Endometrial cancer Fertility preservation Hysteroscopy Infertility Progestins 

Notes

Author contributions

PG: conceptualization and manuscript writing.

Funding

None.

Compliance with ethical standards

Conflict of interest

The author reports no conflict of interest.

Ethical approval

Not needed.

Informed consent

Not applicable.

Human or animal rights

This article does not contain any studies involving human participants or animals.

References

  1. 1.
    La Russa M, Zapardiel I, Halaska MJ, Zalewski K, Laky R, Dursun P, Lindquist D, Sukhin V, Polterauer S, Biliatis I (2018) Conservative management of endometrial cancer: a survey amongst European clinicians. Arch Gynecol Obstet 298(2):373–380.  https://doi.org/10.1007/s00404-018-4820-7 CrossRefPubMedGoogle Scholar
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    Wei J, Zhang W, Feng L, Gao W (2017) Comparison of fertility-sparing treatments in patients with early endometrial cancer and atypical complex hyperplasia: a meta-analysis and systematic review. Medicine (Baltimore) 96(37):e8034.  https://doi.org/10.1097/MD.0000000000008034 CrossRefGoogle Scholar
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    Ethics Committee of American Society for Reproductive Medicine (2012) Fertility treatment when the prognosis is very poor or futile: a committee opinion. Fertil Steril 98(1):e6–e9.  https://doi.org/10.1016/j.fertnstert.2012.03.045 CrossRefGoogle Scholar
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    American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee (2014) Female age-related fertility decline. Committee opinion No. 589. Fertil Steril 101(3):633–634.  https://doi.org/10.1016/j.fertnstert.2013.12.032 CrossRefGoogle Scholar
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    Nahuis MJ, Oosterhuis GJ, Hompes PG, van Wely M, Mol BW, van der Veen F (2013) The basic fertility workup in women with polycystic ovary syndrome: a systematic review. Fertil Steril 100(1):219–225.  https://doi.org/10.1016/j.fertnstert.2013.03.015 CrossRefPubMedGoogle Scholar
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    Gambadauro P, Gudmundsson J (2017) Endometrial cancer in a woman undergoing hysteroscopy for recurrent IVF failure. Gynecol Surg 14(1):4.  https://doi.org/10.1186/s10397-017-1009-1 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Women’s and Children’s HealthUppsala UniversityUppsalaSweden
  2. 2.Karolinska Institutet, NASP/LIME-C7StockholmSweden
  3. 3.Res Medica SwedenUppsalaSweden

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