Weight loss improve pregnancy and livebirth outcomes in young women with early-stage endometrial cancer and atypical hyperplasia:15 years’ experience

Abstract Background: To evaluate the effects of body weight loss on pregnancy and livebirth outcomes in young women with early-stage endometrial cancer (EC) and atypical hyperplasia (AH) with fertility-sparing therapy. Thus, improve the management of this patient group. Method: Patients with AH (n=36) and well-differentiated EC (n=8, FIGO stage IA) who achieved complete regression after conservative treatment were included in this retrospective study. A weight loss group (n=25) and a non-weight loss group (n=19) were divided; while subgroup analysis according to body mass index and stratification analysis according to weight loss proportion were performed to investigate the effect of weight loss on pregnancy and livebirth outcomes. A univariate and multivariate logistic regression analysis were undertaken to analysis the factors associated with pregnancy. Results: The mean body weight and body mass index at pretreatment of progestin and initiation of fertility treatment was 70.63±12.03 and 67.08±8.18 kg, respectively, and 27.06±4.44 and 25.73±3.15 kg/m2, respectively. 25 patients (56.82%) had weight loss; the median weight loss amount is 5.00kg (1.00-34.50), median weigh loss proportion was 6.70% (1.00-36.00) during median time interval of 12months (5.00-97.00). An impressive favorable pregnancy rate (65.91%) and live birth rate (50.00%) were achieved. The pregnancy and livebirth rate were meaningfully higher in the weight loss group than the non-weight loss group (88.00% vs.36.84%,P=0.000; 64.00% vs.31.58%,P=0.033, respectively); weight loss≥5% significantly increased pregnancy and live birth rate in patients with BMI≥25. The risk ratios of weight loss≥5% in multivariate logistic analysis for pregnancy was 0.096(0.010, 0.907). Conclusions: Weight loss could have a positive effect on pregnancy rates and seem to be useful for improving live birth rates in overweight or obese women with early-stage endometrial cancer and atypical hyperplasia during/after fertility-sparing therapy. weight loss≥5% was protective factors of pregnancy in fertility-sparing patients with early-stage endometrial cancer and atypical hyperplasia.