Gonadotropin releasing hormone agonist and levonorgestrel-intrauterine device followed by in vitro fertilization program as management strategy for an infertile endometrial cancer patient: a case report

Gynecol Endocrinol. 2013 Mar;29(3):219-21. doi: 10.3109/09513590.2012.738726. Epub 2012 Nov 16.

Abstract

Background: A progressive delay in the age of first conception results in an increased frequency of endometrial cancer patients in reproductive age and desiring childbearing.

Case: A 38-year-old infertile woman with stage I endometrioid adenocarcinoma was treated with gonadotropin releasing hormone agonist (GnRHa) and levonorgestrel-releasing intrauterine device (LNG-IUD). After disease remission, she underwent a controlled ovarian stimulation for standard in vitro fertilization (IVF) program and had a pregnancy delivering a healthy male baby. Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy was performed four months after delivery. The patient is free of disease after 3-year follow-up.

Conclusion: GnRHa plus LNG-IUD followed by IVF program is a safe and effective fertility-sparing strategy to manage infertile patients with stage I endometrial cancer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Carcinoma, Endometrioid / drug therapy
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / physiopathology
  • Carcinoma, Endometrioid / surgery
  • Contraceptive Agents, Female / administration & dosage
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Delayed-Action Preparations / therapeutic use
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / physiopathology
  • Endometrial Neoplasms / surgery
  • Endometrium / drug effects
  • Endometrium / pathology
  • Female
  • Fertility Preservation*
  • Fertilization in Vitro*
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / adverse effects
  • Gonadotropin-Releasing Hormone / agonists*
  • Gonadotropin-Releasing Hormone / therapeutic use
  • Humans
  • Infertility, Female / drug therapy
  • Infertility, Female / etiology
  • Infertility, Female / therapy*
  • Intrauterine Devices, Medicated*
  • Leuprolide / adverse effects
  • Leuprolide / therapeutic use
  • Levonorgestrel / administration & dosage*
  • Neoplasm Staging
  • Pregnancy
  • Remission Induction
  • Term Birth

Substances

  • Antineoplastic Agents, Hormonal
  • Contraceptive Agents, Female
  • Delayed-Action Preparations
  • Gonadotropin-Releasing Hormone
  • Levonorgestrel
  • Leuprolide