Fertility Preservation

Question 0

Prior to fertility preservation after the work up what other consultations to you a team prior to therapy?

Answer 0

Genetic counseling, reproductive endocrinology.

Question 1

And whom do you offer fertility sparing options?

Answer 1

Grade one on D&C, stage one based on imaging, no contraindications to medical therapy or pregnancy. And I counsel them that this is not the standard of care.

Question 2

How do you treat for fertility preservation?

Answer 2

I offer Megace, medroxyprogesterone, or levonorgestrel IUD. I then sample every 3 to 6 months.

Question 3

How long do you treat with hormones for fertility sparing and initial cancer?

Answer 3

If at six months there’s a complete response, then I encourage pregnancy but continue surveillance every 3 to 6 months. If there is progression I offer hysterectomy. I also offer hysterectomy if there is no response at nine months. And hysterectomy after childbearing complete.

Question 4

What are contraindications to progestin therapy?

Answer 4

Breast cancer, stroke, heart attack, pulmonary embolism, DVT, smoking

Question 5

What is the complete response rate when using hormones?

Answer 5

50%. However the recurrence rate is high 35%.

Question 6

What is the pregnancy rate?

Answer 6

35%