A Successful Live Twin Birth by In Vitro Fertilization after Conservative Treatment of Recurrent Endometrial Cancer

Endometrial cancer is predominately a postmenopausal disease. Endometrial cancer inwomen of childbearing age is relatively unusual. Endometrial cancer is typically treated withhysterectomy. After the development of endometrial cancer, successful pregnancy is rare.We present a case of recurrent stage I endometrial adenocarcinoma in a 35-year-old woman.Magnetic resonance imaging (MRI) revealed endometrial lesions without myometrium invasionand no pelvic lymph node enlargement. The patient refused surgical intervention withabdominal hysterectomy and bilateral salpingo-oophorectomy because of her essential desirefor children. Fertility-preserving medical therapy with megestrol acetate for 1 year and subsequentassisted reproductive treatment (ART) were performed. Successful pregnancyoccurred after in vitro fertilization-embryo transfer (IVF-ET). On the basis of these observationsand the low malignant potential of well-differentiated endometrial carcinoma, fertilitypreservingtreatment using Megace therapy was suggested. In this case, recurrence occurredafter the completion of Megace therapy and three failed attempts at artificial insemination bythe husband (AIH). Recurrent endometrial adenocarcinoma was documented using hysteroscopyand direct endometrial biopsy. Another course of Megace therapy was administereddue to her desire for children. A successful pregnancy occurred after long-term medicaltreatment and IVF-ET.