Fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer

In light of the low certainty of the evidence, it is unclear which intervention and which route of administration or dose of progestins could be of benefit compared to others for fertility-sparing management of endometrial cancer or AEH. The addition of metformin to progestins may increase complete response slightly. Levonorgestrel IUS may result in no difference in efficacy in complete response, compared to oral progestins, whilst it may reduce adverse events slightly. Therefore, levonorgestrel IUS may improve quality of life and compliance with treatment.