Effects of levonorgestrel-releasing intrauterine system on recurrence and fertility outcomes during assisted reproduction after complete remission of early endometrioid endometrial cancer and precancerous lesions: A retrospective cohort study.

The study (DOI: 10.1002/ijc.35465) evaluated the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) during controlled ovarian stimulation (COS) in patients with early-stage Grade 1 endometrioid endometrial carcinoma (EEC) or endometrial atypical hyperplasia (EAH) after fertility-preserving treatment.

Among 176 women undergoing IVF and embryo transfer, 21% had LNG-IUS inserted during COS.

The LNG-IUS group showed a significantly lower disease recurrence rate at 1 year post-COS (5.4% vs. 20.9%, p = .034) and was associated with a reduced recurrence risk (HR = 0.203, p = .048).

Fertility outcomes were not adversely affected by LNG-IUS use, including:

• Oocyte yield
• Embryo transfer
• Clinical pregnancy rate (65.3%)
• Cumulative live birth rate (46.6%)

These findings suggest that LNG-IUS during COS can reduce endometrial lesion recurrence without compromising fertility outcomes in EEC/EAH patients.