Analysis of the clinical outcome of in vitro fertilization in infertility patients with conservative treatment of atypical endometrial hyperplasia and early well-differentiated endometrial adenocarcinoma

Objective To investigate the timing, efficacy and safety of in vitro fertilization (IVF) in infertility patients with conservative treatment of atypical endometrium hyperplasia (AEH) and early well-differentiated endometrial adenocarcinoma (EC). Methods The clinical data of infertility patients with conservative treatment of AEH and early high differentiation EC, who underwent IVF treatment were retrospectively analyzed according to the time to start IVF after endometrial pathology confirmed that the lesion completely response (CR), the patients were divided into ≤ 3 months (group A, n=35) and > 3 months (group B, n=25). The clinical outcomes of the two groups were compared. Results A total of 60 patients were included, 45 with AEH and 15 with EC. The follow-up time from the first time to achieve CR was (39.6±26.9) months. Totally 95 IVF cycles were performed, including 67 fresh embryo transfer cycles, the rate of pregnancy per cycle was 38.8% (26/67), and 54 frozen-thawed embryo transfer (FET) cycles, the rate of pregnancy per cycle was 25.9% (14/54). A total of 36 patients were pregnant 47 times, 25 patients delivered 32 live births. There were no statistical differences in the IVF-ET cycle pregnancy rate and FET cycle pregnancy rate between the two groups, and the recurrence rate was significantly higher in group B (48.0%) than in group A (17.1%, P=0.022), with a statistical significance. Multifactorial analysis showed that only the time of IVF treatment after the first CR was related to recurrence (P=0.002, OR=1.078, 95% CI=1.027-1.132). The total recurrence rate was 30.0% (18/60) during the follow-up period, with no disease progression and adverse events. Conclusion Infertility patients with conservative treatment of AEH and early well-differentiated EC undergoing IVF treatment is relatively safe and effective. Recurrence is associated with the time of IVF treatment after the first time to achieve complete response, in order to reduce recurrence, IVF should be used as soon as possible. Key words: Infertility; Endometrium; Atypical hyperplasia; Endometrial adenocarcinoma; In vitro feritliaztion (IVF)