Cancer Research Lab

In vitro fertilization (IVF) may be safely undertaken in women conservatively treated for well differentiated endometrial carcinoma, according to a report in the December Fertility and Sterility.

“Fertility preservation is a rapidly developing field, and it is important that the different available options for fertility preservation be known worldwide for every woman facing cancer treatment,” Dr. Shai E. Elizur from McGill Reproduction Center, Royal Victoria Hospital, Montreal, said. “Young women facing gonadotoxic treatment should be referred as soon as possible to a fertility specialist to consider fertility preservation options.”

Dr. Elizur and colleagues report the IVF characteristics and outcomes of 8 nulliparous women conservatively treated for well-differentiated endometrial adenocarcinoma who underwent 31 IVF cycles at Chaim Sheba Medical Center, Rabin Medical Center, or Laniado Hospital, all in Israel.

Compared with their total IVF population, the authors report, there were significantly more cycles in the endometrial carcinoma group in which the endometrial thickness was less than 8 mm, and none of the women in this group had endometrial responses of more than 10 mm (compared with 43.8% of IVF cycles in the total IVF population with endometrial thickness above 10 mm).

The fertilization rate of 58.6% in this group did not differ from the overall IVF population, the report indicates, and 6 of the 8 women (75%) conceived.

The pregnancy rates were 28% per cycle and 29.2% per transfer, the investigators say, and 4 women delivered 6 healthy offspring.

Three women experienced a recurrence of endometrial carcinoma within 18 to 44 months, the researchers note, but all were successfully retreated.

“Since hormonal treatment for endometrial cancer is still experimental, we follow these patients very closely by repeated endometrial samplings every 3-6 month,” Dr. Elizur said. “We would recommend definitive surgical treatment when the woman completed her family planning.”

“In vitro fertilization is probably a reasonable treatment option, because it will shorten the interval from the conservative to definitive cancer treatment along with offering the opportunity to cryopreserve embryos for future use combined with surrogacy,” the authors conclude.