Clémentine Gonthier1, Francine Walker2, Dominique Luton3, Chadi Yazbeck1, Patrick Madelenat1, Martin Koskas4. 1. Department of Obstetrics and Gynecology, APHP Hôpital Bichat, Paris, France. 2. Department of Pathology, APHP Hôpital Bichat, Paris, France. 3. Department of Obstetrics and Gynecology, APHP Hôpital Bichat, Paris, France; Paris Diderot University Paris 07, France. 4. Department of Obstetrics and Gynecology, APHP Hôpital Bichat, Paris, France; Paris Diderot University Paris 07, France; UMR S 938, CdR St Antoine UPMC University Paris 06, France; EA 7285, UVSQ, Montigny-le-Bretonneux, France. Electronic address: martin.koskas@bch.aphp.fr.
Abstract
OBJECTIVES: The aim of the present study was to evaluate the impact of obesity on reproductive and oncologic outcomes on the success of fertility-sparing management. METHODS: This retrospective multicenter cohort study included women treated conservatively for atypical hyperplasia (AH) and endometrial cancer (EC) to preserve fertility. Five inclusion criteria were defined: (i) the presence of AH or grade 1 EC confirmed by two pathologists; (ii) adequate radiological examination before conservative management; (iii) available body mass index (BMI) at the beginning of treatment; and (iv) a minimum follow-up time of six months. RESULTS: Forty patients fulfilled the inclusion criteria (17 had EC, and 23 had AH), mean age and BMI were 33 years and 29kg/m(2) respectively. Among the 15 obese patients, after medical treatment, 10 patients responded (67%) and three relapsed, whereas in the 25 non-obese patients, 19 responded (76%) and three relapsed (p=0.72). The overall pregnancy rate and follow-up time were 35% and 35 months respectively. Among the 15 obese patients, after medical treatment, two patients became pregnant, whereas in the 25 non-obese patients, 12 became pregnant (p=0.04). CONCLUSION: Despite similar response and recurrence rates, our results suggest that fertility-sparing management for AH and EC is associated with a lower probability of pregnancy in obese patients.
OBJECTIVES: The aim of the present study was to evaluate the impact of obesity on reproductive and oncologic outcomes on the success of fertility-sparing management. METHODS: This retrospective multicenter cohort study included women treated conservatively for atypical hyperplasia (AH) and endometrial cancer (EC) to preserve fertility. Five inclusion criteria were defined: (i) the presence of AH or grade 1 EC confirmed by two pathologists; (ii) adequate radiological examination before conservative management; (iii) available body mass index (BMI) at the beginning of treatment; and (iv) a minimum follow-up time of six months. RESULTS: Forty patients fulfilled the inclusion criteria (17 had EC, and 23 had AH), mean age and BMI were 33 years and 29kg/m(2) respectively. Among the 15 obesepatients, after medical treatment, 10 patients responded (67%) and three relapsed, whereas in the 25 non-obesepatients, 19 responded (76%) and three relapsed (p=0.72). The overall pregnancy rate and follow-up time were 35% and 35 months respectively. Among the 15 obesepatients, after medical treatment, two patients became pregnant, whereas in the 25 non-obesepatients, 12 became pregnant (p=0.04). CONCLUSION: Despite similar response and recurrence rates, our results suggest that fertility-sparing management for AH and EC is associated with a lower probability of pregnancy in obesepatients.
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