Analysis of IVF/ICSI outcomes in infertile women with early-stage endometrial cancer and atypical endometrial hyperplasia after conservative treatment

Purpose To investigate the in vitro fertilization/intracytoplasmic sperm injection (IVF/ ICSI) outcomes and identify factors that might affect live births in patients with early-stage endometrial cancer (EEC) and atypical endometrial hyperplasia (AEH). Methods This retrospective study was performed in a tertiary hospital. Patients (n = 123) with EEC or AEH, who underwent IVF/ICSI treatment between January 2010 and December 2019, were divided into a live birth group and a non-live birth group. Clinical characteristics and IVF/ ICSI outcomes were assessed. Results A total of 123 patients (28 with EEC and 95 with AEH) underwent 215 ovarian stimulation cycles, resulting in 121 fresh embryo transfer ( ET) and 108 frozen- thawed ET. Among 229 ET cycles, 91 (23.7%) of 384 embryos were implanted and 86 pregnancies were achieved, including five ectopic pregnancies (5.8%), 28 miscarriages (32.6%), and 53 live births (61.6%). The clinical pregnancy and live birth rates in each ET cycle were 37.6% and 23.1%, respectively. Fifty-one patients gave birth to 57 live neonates, and the cumulative live birth rate was 41.46%. Multiple logistic regression analysis showed that maternal age, histological type, thin endometrium, and time after complete remission (CR) to IVF cycle started were significantly associated with live births. Conclusions The live birth rate after IVF/ICSI is promising in infertile patients with EEC and AEH. A shorter interval between CR and IVF/ICSI treatment might be a positive factor, while age > 35 years, endometrial thickness < 8 mm on the day of ET, and degree of endometrial lesion progressing into carcinoma can negatively influence IVF/ICSI outcomes.

Automated summary

This study investigated the outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in patients with early-stage endometrial cancer (EEC) and atypical endometrial hyperplasia (AEH) and identified factors that might affect live births. The results showed a promising live birth rate in infertile patients with EEC and AEH. A shorter interval between complete remission (CR) and IVF/ICSI treatment was associated with better outcomes, while factors such as age over 35, thin endometrium, and degree of endometrial lesion progressing into carcinoma were negatively associated with IVF/ICSI outcomes.