Retrospective study about reproductive outcomes after MPA therapy

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  • KONISHI Hiromi
    Department of Gynecology, Osaka General Hospital of West Japan Railway Company Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • HAYASHI Masami
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • FUJIWARA Satoe
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • TANAKA Yoshimichi
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • SASAKI Hiroshi
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • TANAKA Tomohito
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • INOKI Chiharu
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University
  • OHMICHI Masahide
    Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University

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Other Title
  • MPA療法後の妊娠についての後方視的検討
  • MPA リョウホウ ゴ ノ ニンシン ニ ツイテ ノ コウホウ シテキ ケントウ

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Abstract

<p>MPA therapy is a fertility preserving treatment for patients with endometrioid adenocarcinoma G1 (EC G1) or atypical endometrial hyperplasia (AEH). However, sufficient evidence has not been accumulated regarding management after MPA therapy. Therefore, we retrospectively examined those cases in which MPA therapy was performed at our hospital.Pathological diagnosis was EC G1 in 30 cases and AEH in 27 cases. Complete response rate was 84% (48/57), recurrence in 28 patients (49%), and a hysterectomy was performed for all patients. The average observation period after MPA therapy was 91 months. Although no death from the primary disease was observed, progressive disease was observed in two cases. Of the 32 patients which tried to become pregnant, 13 of them were successful (40.6%), and 17 live babies were born. Of these 13 pregnant cases, 10 (76.9%) required fertility treatment and five(38.5%) required assisted reproductive technology (ART). Even in complete response cases leading to pregnancy, recurrence occurred in 41.7% of them, and the period until recurrence was about two years. It is desirable that early pregnancy should be aimed in patients with EC or AEH after MPA therapy. [Adv Obstet Gynecol, 73(3) : 185-190, 2021 (R3.8)]</p>

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