Received November 29, 2019
Accepted June 01, 2020

Objectives: To evaluate the oncologic and reproductive outcomes of patients with atypical endometrial hyperplasia and low grade stage 1 endometrial cancer who received medical treatment. Methods: A retrospective study was conducted on all patients aged 20-42 years with complex, atypical endometrial hyperplasia, and low grade endometrial cancer stage 1, who wished to preserve fertility and were treated at Royal Hospital. This study wad conducted between January 2006 and December 2016. Patients received oral megestrol acetate with or without levenorgestrel intrauterine system. Response to progestin treatment was assessed in terms of duration of therapy, time to response, pregnancy, time of surgery, and oncological outcome. Statistical analysis was performed using SPSS 20.0 software. Results: Twenty patients met the inclusion criteria and among them, 90% had complete remission. Among 90%, 55% had complete remission within six months of treatment. Recurrence rate was recorded in 11 patients (55%) and it was more frequent in obese patients with body mass index (BMI) of ≥ 30 (p = 0.001), and who had complete response in > 6 months of hormonal treatment. About 15% of patients required hysterectomy and 12 (60%) patients conceived after full treatment. Conclusions: Fertility-sparing treatment of atypical endometrial hyperplasia and grade 1 stage 1 endometrial cancer in reproductive-age women is feasible. However, obese patients (BMI ≥ 30) had a high recurrence rate.