Combined Use of a-GnRH and Intrauterine Levonorgestrel Releasing System in Treatment of Atypical Endometrial Hyperplasia in Women of Reproductive Age
Study Objective: to develop a patient-specific approach to management of patients of reproductive age with atypical endometrial hyperplasia (AEH).
Study Design: prospective study.
Materials and Methods. The study enrolled 50 patients with morphologically confirmed AEH. All patients were retrospectively allocated to two groups based on immunohistochemical marker expression values below and above threshold values — groups I and II, respectively. Group I comprised 39 (78.0 ± 5.9%) patients, whereas group II included 11 (22.0 ± 5.9%) patients. Median age in group I was 33 [27; 37] years old, in group II it was 30 [26; 33] years old. The treatment method was combined hormone therapy with a-GnRH (buserelin acetate 3.75mg) and levonorgestrel-containing intrauterine releasing system.
Study Results. Following therapy, 38 (97.4 ± 2.5%) out of 39 patients in group I had endometrium atrophy in 3 months, 1 (2.6 ± 2.5%) patient — in 6 months (p < 0.001);3 (27.3 ± 13.4%) patients in group II — in 3 months, and 8 (72.7 ± 13.4%) patients — in 6 months (p < 0.001). Where immunohistochemical marker expression values are below threshold values, a-GnRH (three times) + LNG-IUS regimen was prescribed, and where values are above threshold values — a-GnRH (six times) + LNG-IUS regimen.
No information on disease relapses in treated women is currently available. After treatment, 15 (30.0 ± 6.0%) women conceived.
Conclusion. Combined hormone therapy is efficient for treatment of AEH in fertile women wishing to have children.
Contribution: Pashov, A.I. — study concept and design, material collection and processing, article preparation, editing; Sivova, E.N. — study concept and design, material collection and processing, statistical data processing, article preparation; Metrinskiy, Ya.Yu. — article preparation, editing.
Conflict of interest: The authors declare that they do not have any conflict of interests.
A.I. Pashov (Corresponding author) — Immanuil Kant Baltic Federal University; 14 Alexander Nevskiy Str., Kaliningrad, Russian Federation 236016. eLIBRARY.RU SPIN: 5022-8272. E-mail: firstname.lastname@example.org
E.N. Sivova — Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky of the Ministry of Health of Russia; 1 Partisan Zheleznyakov Str., Krasnoyarsk, Russian Federation 660022. eLIBRARY.RU SPIN: 3444-6028. E-mail: email@example.com
Ya.Yu. Metrinskiy — Immanuil Kant Baltic Federal University; 14 Alexander Nevskiy Str., Kaliningrad, Russian Federation 236016. E-mail: firstname.lastname@example.org
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