Effectiveness of Intrauterine Levonorgesterel-Releasing Device in the Treatment of Endometrial Hyperplasia in Obese Patients

Aim: Endometrial hyperplasia (EH) is a precursor lesion of endometrial adenocarcinoma, the most common gynecological malignancy in women. Endometrial hyperplasias divided in two groups: non-atypical hyperplasia and atypical hyperplasia. The most commonly used treatment approach is progestin therapy for non-atypical hyperplasias. In this study, we aimed to compare the regression outcomes in control biopsies between obese and non obese patients diagnosed with non-atypical endometrial hyperplasia who were treated with an LNG-IUD and followed up in our clinic. Methods: This study conducted was patients were diagnosed with non-atypical endometrial hyperplasia via endometrial biopsy and treated with intrauterine levonorgestrel. Patient data were reviewed retrospectively. Patients were divided into two groups based on BMI: obese and non-obese. İn regression and treatment success were assessed between control endometrial biopsies taken at 6 and 12 months in the obese and non-obese groups. Results: A total of 110 patients were included in the study who were categorized into two groups according to BMI as obese and non-obese. Data of 32 patients in the obese patient group and 78 patients in the non-obese patient group were examined. In obese patients, the regression rate at the 6th month was 62.5%, and the regression rate at the 12th month was 90.6%. In non-obese patients, the regression rate at the 6th month was 96%, and the regression rate at the 12th month was 97.4%. In the obese patient group, both the 6th-month regression rate and the 12th-month regression rate were statistically significantly lower compared to the non-obese patient group. (p < 0.05). Conclusions: Obesity negatively affects the response to progesterone treatment and that regression rates decrease as BMI increases.