Prospective study of fertility-sparing treatment with chlormadinone acetate for endometrial carcinoma and atypical hyperplasia in young women.

Objective Fertility-sparing treatment is based on progestin therapy and is known to be safe and effective. International recommendations advise the use of megestrol acetate or medroxyprogesterone acetate. However, chlormadinone acetate has fewer undesirable effects and can be used in patients with a history of thromboembolism who are at high vascular risk. In the present prospective study, we aimed to confirm that the efficiency of the use of chlormadinone acetate for 6 months to obtain remission of atypical hyperplasia or endometrial carcinoma is comparable to that of the use of other fertility-sparing treatments. Method The present study is based on the PREFERE prospective registry. All the patients received three or six months of chlormadinone acetate and were evaluated by hysteroscopic resection and pipelle sampling every three months. Results Ninety-four patients were included. Seventy-nine patients achieved complete remission at 6 months (84%). No patients stopped treatment due to a lack of tolerance. Twenty-four percent of the patients achieved a live birth. Conclusion Chlormadinone acetate is an effective and well-tolerated fertility-sparing treatment. Its benefits over other progestins are its tolerability, and its absence of contraindications which makes chlormadinone acetate a good choice for patients with thromboembolism and high vascular risk.