{"entity":{"id":"fertility-sparing-endometrial","kind":"technology","name":"Fertility-sparing hormonal treatment of early endometrial cancer","aka":[],"tldr":"For young women with the earliest, low-grade endometrial cancers, progestin pills or a hormonal IUD can clear the cancer and allow pregnancy before a later hysterectomy.","summary":"Candidates: grade 1 endometrioid carcinoma confined to the endometrium on MRI, PR-positive, no myometrial invasion. Complete response ~70-80% at 12 months with oral megestrol/medroxyprogesterone or a levonorgestrel IUD (often combined with metformin or hysteroscopic resection); recurrence ~30%; live-birth rates ~30-40% with assisted reproduction. Hysterectomy after childbearing is recommended.","status":"established","asOf":"2026-09-07","links":[{"label":"Rodolakis et al., ESGO/ESHRE/ESGE guidelines for the fertility-sparing treatment of patients with endometrial carcinoma (International Journal of Gynecological Cancer 2023)","url":"https://doi.org/10.1136/ijgc-2022-004047"}],"tags":[],"related":[],"cancers":["endometrial"],"sections":["hormonal","surgery","rejuvenation"],"technologies":["mri","endocrine-therapy"],"targets":[],"drugs":["megestrol-progestins"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-rodolakis-int-j-gynecol-cancer"],"journals":[],"dependsOn":[],"notes":[],"principle":"Progestin-induced differentiation and apoptosis of hormone-responsive endometrial cancer cells under close endometrial sampling surveillance.","strengths":["Preserves fertility in a disease increasingly diagnosed in women under 45","Minimal toxicity"],"limitations":["Recurrence risk ~30%","Requires strict imaging and biopsy follow-up","Not appropriate for grade 2-3, p53-abnormal, or invasive disease"]},"route":"/technologies/fertility-sparing-endometrial/","neighbours":{"cancer":[{"id":"endometrial","kind":"cancer","name":"Endometrial cancer","route":"/cancers/endometrial/"},{"id":"endometrial-nsmp","kind":"cancer","name":"Endometrial cancer with no specific molecular profile","route":"/cancers/endometrial-nsmp/"}],"section":[{"id":"hormonal","kind":"section","name":"Hormonal Therapy","route":"/fronts/hormonal/"},{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"endocrine-therapy","kind":"technology","name":"Endocrine therapy (SERMs, AIs, SERDs)","route":"/technologies/endocrine-therapy/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"}],"drug":[{"id":"megestrol-progestins","kind":"drug","name":"Progestins (megestrol acetate, medroxyprogesterone, levonorgestrel IUD)","route":"/drugs/megestrol-progestins/"}],"paper":[{"id":"paper-rodolakis-int-j-gynecol-cancer","kind":"paper","name":"ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma","route":"/key-papers/paper-rodolakis-int-j-gynecol-cancer/"}],"bottleneck":[{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"}]}}