Endometrial Cancer & ICSI Insights

What is the survival rate for patients with Stage 1 cancer who undergo surgery?

Which procedure is typically used for management at Stage 2 cancer?

What should be administered to a patient before an endometrial biopsy to reduce discomfort?

What is a potential complication associated with endometrial biopsy?

Which additional investigations may be considered for a comprehensive evaluation before taking a biopsy?

What is the lifetime risk of developing endometrial cancer for women?

Which age group has the highest incidence of stage 1 endometrial cancer?

Which of the following is NOT a risk factor for endometrial cancer?

What percentage of patients with endometrial cancer have inherited mutations?

What initial examination is suggested when assessing for endometrial cancer symptoms?

If the endometrial thickness is found to be less than 4 mm during a transvaginal ultrasound, what is the next step?

What condition is associated with an increased risk of developing colorectal and ovarian cancers?

What is the most common symptom indicating potential endometrial cancer in postmenopausal women?

Indications for ICSI

ICSI is used for severe male infertility with azoospermia.

Sperm Aspiration Techniques

TSA: Testicular Sperm Aspiration
TSE: Testicular Sperm Extraction
PSA: Percutaneous Sperm Aspiration
HESA: Microsurgical Epididymal Sperm Aspiration

Endometrial Cancer

It's a common cancer among postmenopausal women, often occurring in the 70-74 age group.
Incidence is approximately 95 per 100,000 women
Average diagnosis age is 62
Risk increases over a 20-year period as a consequence of aging.

Risk Factors for Endometrial Cancer

Unopposed estrogen (high serum estrogen with no progesterone)
Age 45+
Obesity
Tamoxifen use (72 months or longer)
Lynch syndrome
Previous pelvic radiation therapy

Other Risks

Exposure to both extrinsic and intrinsic estrogens, such as obesity, androgens, or changes in ovarian function
Estrogen therapy with no progesterone
Nulliparity
Early menarche
Endometroid tumors caused by sporadic mutations but about 5% of cases have inherited mutations.

Clinical Features of Endometrial Cancer

90% present with postmenopausal bleeding
Pelvic exam may reveal vaginal atrophy, and a mass might be palpated.

Investigations

Transvaginal ultrasound (TVUS): helps visualize endometrial thickness
If endometrial thickness is <4mm, it's normal and no further investigations are necessary.
If >5mm, regular biopsies, hysteroscopy, or D&C might be needed.
Endometrial biopsy can be performed during hysteroscopy or D&C for accurate diagnosis.

Diagnostic Procedures

Hysteroscopy with endometrial biopsy for accurate and rapid diagnosis, especially if endometrial sampling demonstrates significant growth or atypical findings.
Fine needle aspiration technique for accurate diagnosis if traditional methods demonstrate difficulty or other limitations.

Staging of Endometrial Cancer

Stages 1A and 1B are categorized by proximity to the serosa, cervix, vagina, bladder, and rectum. (Specific values in the document)

Treatment

Stage 1: Surgery—typically laparoscopic total hysterectomy with bilateral salpingo-oophorectomy
Stage 3: Debulking and removal of any remaining metastases; chemotherapy/radiation may be required if necessary
Stage 4: Palliative treatment.

This quiz covers critical insights into indications for Intracytoplasmic Sperm Injection (ICSI) and key information about endometrial cancer. You'll explore sperm aspiration techniques and the risk factors associated with endometrial cancer in postmenopausal women. Test your understanding and enhance your knowledge in reproductive health and cancer awareness.