Successful in vitro fertilization pregnancy after conservative management of endometrial cancer

Objective: To report a successful IVF pregnancy in an infertile couple after conservative treatment of endometrial cancer. Design: Case report and literature review. Setting: University teaching hospital. Patient(s): A 29-year-old infertile white woman. Main Outcome Measure(s): Successful pregnancy after conservative management of endometrial cancer. Intervention(s): Grade 1 endometrial adenocarcinoma diagnosed at hysteroscopy, followed by dilatation and curettage (D&C). On follow-up D&C, pathologic examination was normal after high-dose progesterone therapy. The patient subsequently underwent an IVF cycle with transfer of three blastocysts. Result(s): The patient delivered triplets by cesarean section. Laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy was then done. No residual endometrial cancer was evident in the hysterectomy specimen, but a 1.1-cm cystic mixed endometrioid and clear cell-type adenocarcinoma was discovered in the left ovary. The patient is doing well after 3 cycles of chemotherapy; her CA-125 level is normal. The triplets are also doing well. Conclusion(s): In carefully chosen situations, deferring surgery in infertile patients with endometrial cancer may be a viable option permitting subsequent successful pregnancy.