Trial reportJournal of assisted reproduction and genetics2024
A multi-centre randomised controlled trial comparing megestrol acetate to levonorgestrel-intrauterine system in fertility sparing treatment of atypical endometrial hyperplasia.
Trial report in Journal of assisted reproduction and genetics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05492487 (A Pilot Study on Fertility Conservative Treatment of Atypical Endometrial Hyperplasia in Singapore), which is not on this map. Cited by 7 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Pilot Study on Fertility Conservative Treatment of Atypical Endometrial Hyperplasia in Singapore
Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Fertility-preserving treatment for endometrial atypical hyperplasia and endometrial cancer: a systematic review and meta-analysis.BMC women's health · 2026Pooled it
- Fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer.The Cochrane database of systematic reviews · 2025Pooled it
- Efficacy and related factors of levonorgestrel-releasing intrauterine system combined with metformin in fertility-preserving treatment for atypical endometrial hyperplasia and early endometrial cancer: A retrospective cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Global Perspective on Fertility-Sparing Surgical Oncology in Gynaecology: A Narrative Literature Review.Cureus · 2026Review
- Review
- POLE-mutated atypical endometrial hyperplasia in an adolescent: a 5-year follow-up with LNG-IUS-a case report and literature review.BMC women's health · 2025Review
- A Decade of Experience in Diagnostic and Conservative Treatment of Endometrial Malignancy-Oncologic and Obstetrical Outcomes from a Referral Oncofertility Center.Diagnostics (Basel, Switzerland) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
purposeThe objective of the trial was to compare the regression rate of atypical endometrial hyperplasia (AEH) in patients treated with megestrol acetate (MA) vs. levonorgestrel-intrauterine device (LNG-IUS). We also aimed to assess the fertility and pregnancy outcomes in these patients.
methodsThe study was a phase II multi-centre randomised controlled trial on the use of MA compared to LNG-IUS in the treatment of AEH conducted from January 2020 to January 2024 in Singapore. Women who were diagnosed with AEH and between 21 and 40 years old were included. The patients were randomised to receive either MA (160 mg orally daily) or LNG-IUS. The primary outcomes assessed were the regression rates at 3 months, 6 months and 9 months of treatment. The secondary outcomes assessed were the side effects, patient acceptability and fertility outcomes.
resultsThirty-six patients completed the trial. The overall regression rate was 88.9% by 9 months. There was no statistically significant difference in the 9-month complete regression rate between MA vs. LNG-IUS. There was also no significant difference in side effects and weight change between both arms. Nineteen patients were actively pursuing fertility after complete regression. There were 8 pregnancies achieved, with resultant 4 live births and 4 miscarriages.
conclusionOur study confirms a high regression rate of AH with medical treatment. LNG-IUS is a non-inferior treatment compared to megestrol acetate. Successful pregnancy outcomes can be achieved after regression of AEH. Long-term studies of sufficient sample-size are needed to assess for fertility and pregnancy outcomes, risk of recurrence and long-term risk of malignancy. TRIAL REGISTRATION NUMBER: The study was registered with the Health Science Authority (HSA) (License No.: CTA1900087) on September 5, 2019: https://eservice.hsa.gov.sg/prism/ct_r/enquiry.do?action=loadSpecificDetail . The trial was registered retrospectively on ClinicalTrials.gov (ID: NCT05492487) on April 7, 2022: https://clinicaltrials.gov/study/NCT05492487 .
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