A study shows that combining anti-estrogen therapy with metabolic-targeted treatments—like metformin for diabetes or insulin resistance, statins for dyslipidemia, and calcium channel blockers for hypertension—can enhance fertility-preserving outcomes in endometrial cancer (EC) and endometrial atypical hyperplasia (EAH). Among 285 patients treated, 77% achieved complete response within six months, and pregnancy and live birth rates reached 38% and 29%, respectively.
Metformin notably shortened treatment time for patients with insulin resistance or diabetes, while CCBs showed benefits for hypertensive patients. The study highlights that addressing metabolic abnormalities may overcome resistance to traditional progestin therapy and improve both efficacy and reproductive outcomes.
Researchers advocate for larger, multicenter trials to confirm long-term safety, recurrence rates, and fertility results, pointing to a promising future for individualized, metabolism-focused fertility-sparing strategies in EC care.