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Purpose: There has also been an increase in number of women with endometrial carcinoma (EC) in their reproductive years who wish to retain their fertility. We aimed to report the treatment results in EC patients underwent fertility-sparing treatment in Iran. Methods: This is a case-series study conducted on women diagnosed with stage IA, grade 1 EC. Treatment was initiated using either megestrol acetate, medroxyprogesterone acetate (MPA) or MPA and metformin. Patients showing partial remission or disease persistence continued their hormone therapy and those showing disease persistence after 12 months or showing disease progression underwent the standard surgical intervention of hysterectomy and bilateral salpingo-oophorectomy. Bariatric surgery was also performed to improve overall prognosis in those indicated. Results: Our study included 22 subjects, with a mean age of 32.82 ± 5.46 years. Treatment results included complete remission in 10 (45.5%), relative remission in 2 (9.1%), persistence in 4 (18.2%) and disease progression in 6 (27.3%) subjects. 5 (22.7%) subjects had a spontaneous pregnancy and 13 (59.1%) underwent embryo cryopreservation. At 1-year timepoint, 8 (36.3%) subjects had a live birth, including 5 (22.7%) with a spontaneous pregnancy and 3 (13.6%) through a uterine surrogate. Side effects observed from hormonal therapy included weight gain (9.1%) and abnormal blood sugar and liver function tests (4.5%). Conclusion: Overall, a conservative treatment approach to patients with EC aiming to preserve their fertility can be safe and have acceptable outcomes in terms of oncologic response as well as pregnancy results.

Background: Despite the increasing trend in using neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (OC), there is still no consensus on the optimal number of NACT cycles before interval debulking surgery (IDS). We aimed to investigate the differences in outcomes of patients with OC undergoing ≤ 3 and ≥ 4 courses of NACT in Iran. Methods: In a retrospective cohort study, we compared subjects with stage III or IV OC who were treated using NACT followed by IDS. We compared overall survival (OS), disease-free survival (DFS), optimal surgical outcome, treatment response (composite of CA-125 response and radiological response) between those receiving ≤ 3 and ≥ 4 courses of NACT. We used Kaplan–Meier and Log-rank tests to compare survival between the groups. Results: 107 subjects with a mean age of 55.41 ± 11.44 years were included in the final analysis 48 (44.9%) of whom had received ≥ 4 courses of chemotherapy. Participants with a complete treatment response had a lower average of NACT courses compared to those with a partial treatment response (1.83 ± 1.47 vs. 3.90 ± 1.32; p< 0.01). 76.8 and 59.6% of subjects had an optimal surgery in groups with ≤ 3 and ≥ 4 NACT courses, respectively (p= 0.06). There were no significant differences in months of OS (41.66 vs. 33.96; p= 0.31) or DFS (26.71 vs. 19.85; p= 0.46) between those receiving ≤ 3 and ≥ 4 cycles of NACT, respectively. Conclusion: Overall, women treated with ≤ 3 and ≥ 4 NACT courses have no significant differences in terms of OS, DFS or optimal IDS results. It is imperative to focus on developing clear guidelines to enhance early diagnosis, patient selection and optimal chemotherapeutic and surgical interventions.

Background: The placental examination provides important information about the effect of maternal abnormalities on the placenta or the cause of preterm delivery, fetal growth restriction, or fetal neurodevelopmental damage. In this study, the frequency of placental pathologies of patients in a tertiary hospital was investigated. Methods: In this longitudinal and cross-sectional study, all removed placentas after any type of pregnancy termination referred to a pathological examination, within 1 year (2019–2020). All placentas were examined macroscopically and microscopically by two pathologists. Results: Unfortunately, because of the COVID-19 pandemic, the number of pregnant women in our hospital declined. A total of 258 placentas were examined. The type of delivery in 193 cases (79.4%) was cesarean section and 50 cases (20.6%) had a vaginal delivery. In the pathological assessment of placentas, 238 (92.2%) cases were normal and 20 cases (7.8%) were abnormal. Infarct and chorioamnionitis were the pathologies with higher frequencies (4.3% and 2.7%, respectively). Intra-uterine fetal death (p= 0.701), preeclampsia (p= 0.51) had no significant difference was seen in normal and abnormal placentas. Maternal age (p= 0.83), gestational age based on the last menstrual period (p= 0.38), and gestational age based on the first ultrasound (p= 0.78) did not show a significant relationship with any of the pathological complications categories. Conclusions: Pathological examination of the placenta from all live-birth deliveries is not worthwhile, and it’s recommended to modify the guidelines as to when the placenta is submitted for pathological evaluation.

There was an increase in number of patients presented with early-stage cervical cancer (CC). Tumors with favorable pathological features might be candidates for less radical surgery.

Various modalities including ultrasonography and magnetic resonance imaging (MRI) have been developed as imaging technique for screening malignant myometrial tumors, but a few studies assessed the diagnostic value of these two techniques in differentiation of benign from malignant myometrial tumors that had been the main purpose of this study.