Page 126 - ESHRE2019

Atypical EH / EIN
• High risk of progression to endometrial carcinoma15 – 28% based on studies with 20 years follow up
– even at 1st diagnosis
• Hysterectomy is the treatment of choice for most women with
atypical hyperplasia
• Progestin therapyfor fertility preservation:
1. LNG‐IUD (52/5) is the first‐line therapy
2. MA (80 – 160mg/day) is more potent than MPA
Lacey JV Jr, et al, J Clin Oncol 2010; 28:788
Wheeler DT, et al, Am J Surg Pathol 2007; 31:988
LNG‐IUD (52/5) “Mirena”
• 2012 systematic review
• 45 studies (5 prospective)
• N = 391 (111 with atypical EH)
• Regression rate of atypical hyperplasia: 75 – 85%
• LNG 52/5 “Mirena”  progestin of choice
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