Segmented in vitro fertilization and frozen embryo transfer in levonorgestrel-releasing intrauterine device treated patients with endometrial cancer

Abstract

Abstract Purpose To evaluate the efficacy of levonorgestrel-releasing intrauterine device (LNG-IUD) during controlled ovarian stimulation (COS) in patients with early stage endometrioid endometrial cancer (EEC). Methods A retrospective study was conducted. The study population comprised patients with EEC who achieved complete response after fertility-sparing treatment from December 2018 to December 2021 and all the women who underwent COS had LNG-IUDs inserted in the uterine cavity. Results 16 patients were enrolled who underwent 26 COS cycles. The average age was 33.19 ± 4.04 years. 12 patients had 19 subsequent frozen-thawed embryo transfer (FET) cycles, no embryos were obtained in 1 patient, 1 patient got pregnancy spontaneously with term delivery after COS, 1 patient relapsed before FET, and 1 patient did not transfer embryos for personal reasons. Among 19 FET cycles, the clinical pregnancy and live birth rates in each ET cycle were 36.84% (7/19) and 26.32% (5/19), respectively. 7 clinical pregnancies resulted in 2 miscarriages (28.57%), and 5 live births (71.43%). Totally 6 patients achieved 7 live births, the cumulative live birth rate was 37.5% (6/16). Three (18.75%)of these patients relapsed after COS during the follow-up period(31.31 ± 15.89 months). Time interval from COS to relapse was 6.63,11.67 and 16.23 months respectively. Conclusion LNG-IUD may benefit the pregnancy and oncological outcomes of patients with EEC during COS.