BIOMAT Database Logo BIOMAT Database Logo

Safety and efficacy of levonorgestrel-releasing intrauterine device in the treatment of atypical endometrial hyperplasia and early endometrial cancer. 2022

Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.

OBJECTIVE To investigate the recurrence rate, live-birth rate, and treatment outcomes of levonorgestrel-releasing intrauterine device (LNG-IUD) for the management of atypical endometrial hyperplasia (AEH) or Grade-1 endometrial cancer (EC) in patients who desire fertility-sparing treatment and those seeking conservative treatment without fertility preservation. METHODS We prospectively enrolled nine patients from a single institution between April 2009 and September 2013 who were followed up for 60 months after LNG-IUD insertion. RESULTS The median patient age was 35 (range: 29-39) years. The overall recurrence rate was 56% (5/9). The median interval between removal of the LNG-IUD and recurrence was 20.5 (range: 2-30) months. Three of the nine patients had Grade-1 EC, and six had AEH. The response rates to the LNG-IUD in patients with Grade-1 EC and AEH were 66% and 100%, respectively. Four patients (three with AEH, one with Grade-1 EC) experienced recurrence 6 months after MPA treatment and all 4 (100%) had complete response. Eight patients desired fertility preservation, of which 37% (3/8) conceived after receiving fertility treatment and 25% (2/8) had a live birth; the remaining three had previously received MPA for 6 months and had a recurrence; of these, 1 had a live birth. CONCLUSIONS LNG-IUD is effective for the management of AEH and EC in young patients who desire fertility-sparing treatment, including those ineligible for MPA owing to the presence of comorbidities and those with recurrence after MPA treatment (6-month treatment), and patients seeking conservative treatment without fertility preservation.

UI MeSH Term Description Entries
D007436 Intrauterine Devices, Medicated Intrauterine devices that release contraceptive agents. Hormone-Releasing IUDs,IUD, Hormone Releasing,Intrauterine Devices, Hormone-Releasing,Intrauterine Devices, Progesterone-Releasing,Medicated Intrauterine Devices,Device, Hormone-Releasing Intrauterine,Device, Medicated Intrauterine,Device, Progesterone-Releasing Intrauterine,Devices, Hormone-Releasing Intrauterine,Devices, Medicated Intrauterine,Devices, Progesterone-Releasing Intrauterine,Hormone Releasing IUD,Hormone-Releasing IUD,Hormone-Releasing Intrauterine Device,Hormone-Releasing Intrauterine Devices,IUD, Hormone-Releasing,IUDs, Hormone-Releasing,Intrauterine Device, Hormone-Releasing,Intrauterine Device, Medicated,Intrauterine Device, Progesterone-Releasing,Intrauterine Devices, Hormone Releasing,Intrauterine Devices, Progesterone Releasing,Medicated Intrauterine Device,Progesterone-Releasing Intrauterine Device,Progesterone-Releasing Intrauterine Devices
D004714 Endometrial Hyperplasia Benign proliferation of the ENDOMETRIUM in the UTERUS. Endometrial hyperplasia is classified by its cytology and glandular tissue. There are simple, complex (adenomatous without atypia), and atypical hyperplasia representing also the ascending risk of becoming malignant. Atypical Endometrial Hyperplasia,Complex Endometrial Hyperplasia,Simple Endometrial Hyperplasia,Atypical Endometrial Hyperplasias,Complex Endometrial Hyperplasias,Endometrial Hyperplasia, Atypical,Endometrial Hyperplasia, Complex,Endometrial Hyperplasia, Simple,Endometrial Hyperplasias,Endometrial Hyperplasias, Atypical,Endometrial Hyperplasias, Complex,Endometrial Hyperplasias, Simple,Hyperplasia, Atypical Endometrial,Hyperplasia, Complex Endometrial,Hyperplasia, Endometrial,Hyperplasia, Simple Endometrial,Hyperplasias, Atypical Endometrial,Hyperplasias, Complex Endometrial,Hyperplasias, Endometrial,Hyperplasias, Simple Endometrial,Simple Endometrial Hyperplasias
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D016889 Endometrial Neoplasms Tumors or cancer of ENDOMETRIUM, the mucous lining of the UTERUS. These neoplasms can be benign or malignant. Their classification and grading are based on the various cell types and the percent of undifferentiated cells. Cancer of Endometrium,Endometrial Cancer,Endometrial Carcinoma,Cancer of the Endometrium,Carcinoma of Endometrium,Endometrium Cancer,Neoplasms, Endometrial,Cancer, Endometrial,Cancer, Endometrium,Cancers, Endometrial,Cancers, Endometrium,Carcinoma, Endometrial,Carcinomas, Endometrial,Endometrial Cancers,Endometrial Carcinomas,Endometrial Neoplasm,Endometrium Cancers,Endometrium Carcinoma,Endometrium Carcinomas,Neoplasm, Endometrial
D016912 Levonorgestrel A synthetic progestational hormone with actions similar to those of PROGESTERONE and about twice as potent as its racemic or (+-)-isomer (NORGESTREL). It is used for contraception, control of menstrual disorders, and treatment of endometriosis. 18,19-dinorpregn-4-en-20-yn-3-one, 13-ethyl-17-hydroxy-, (17alpha)-(-)-,l-Norgestrel,Capronor,Cerazet,D-Norgestrel,Microlut,Microval,Mirena,NorLevo,Norgeston,Norplant,Norplant-2,Plan B,Vikela,duofem,D Norgestrel,Norplant 2,Norplant2,l Norgestrel
D059247 Fertility Preservation A method of providing future reproductive opportunities. Typically CRYOPRESERVATION of reproductive organs or tissues (e.g., sperm, egg, embryos and ovarian or testicular tissues) are carried out before known risk of loss of fertility (e.g., chemotherapy, radiation or military deployment) begins for future use. Egg Freezing,Sperm Freezing,Fertility Preservations,Freezing, Egg,Freezing, Sperm,Preservation, Fertility

Related Publications

Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Treatment of Low-Risk Endometrial Cancer and Complex Atypical Hyperplasia With the Levonorgestrel-Releasing Intrauterine Device.
January 2018, Obstetrics and gynecology,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Levonorgestrel-releasing intrauterine system for atypical endometrial hyperplasia.
June 2013, The Cochrane database of systematic reviews,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Treatment of nonatypical and atypical endometrial hyperplasia with a levonorgestrel-releasing intrauterine system.
May 2003, American journal of obstetrics and gynecology,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Treatment of endometrial hyperplasia with levonorgestrel releasing intrauterine devices.
January 1987, Acta Europaea fertilitatis,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Levonorgestrel-releasing intrauterine system for endometrial hyperplasia.
September 2020, The Cochrane database of systematic reviews,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Progression of atypical endometrial hyperplasia to adenocarcinoma despite intrauterine progesterone treatment with the levonorgestrel-releasing intrauterine system.
February 2008, Obstetrics and gynecology,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Prospective phase II trial of levonorgestrel intrauterine device: nonsurgical approach for complex atypical hyperplasia and early-stage endometrial cancer.
February 2021, American journal of obstetrics and gynecology,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Levonorgestrel-releasing intrauterine device versus dydrogesterone for management of endometrial hyperplasia without atypia.
March 2015, Reproductive sciences (Thousand Oaks, Calif.),
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
The combined GnRH-agonist and intrauterine levonorgestrel-releasing system treatment of complicated atypical hyperplasia and endometrial cancer: a pilot study.
July 2012, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology,
Toru Hirata, and Eiji Kondo, and Shoichi Magawa, and Michiko Kubo-Kaneda, and Masafumi Nii, and Kenta Yoshida, and Tadashi Maezawa, and Tsutomu Tabata, and Tomoaki Ikeda
Hysteroscopic Endometrial Focal Resection followed by Levonorgestrel Intrauterine Device Insertion as a Fertility-Sparing Treatment of Atypical Endometrial Hyperplasia and Early Endometrial Cancer: A Retrospective Study.
January 2019, Journal of minimally invasive gynecology,
Copied contents to your clipboard!