Table 1.

Scientific societies’ guidelines on selection of women with endometrial cancer that are candidates for fertility sparing management.

Scientific Society	Selection Criteria for Fertility Sparing Treatment
	Histology	Tumor Stage	Specimen Obtainment Method and Recommended Imaging Modality	Other Recommendations
ESGO-ESTRO-ESP Consensus Conference on Endometrial Cancer [12]	Well-differentiated (grade 1) endometrial adenocarcinoma or premalignant state (atypical hyperplasia).	Tumor confined to the endometrium. No extrauterine involvement (adnexal or pelvic nodes).	Histology and grade confirmed by hysteroscopy by an expert pathologist. Myometrial invasion or adnexal involvement excluded by MRI. Expert ultrasound can be considered as an alternative.	Women should understand the non-standard nature of conservative treatment and the need for close follow-up. Women must be informed of the need for future hysterectomy.
The American College of Obstetricians and Gynecologists (ACOG) and Society of Gynecologic Oncology (SGO) Clinical management guidelines [13]	A well-differentiated, grade 1, endometrioid endometrial carcinoma.	No myometrial invasion. No extrauterine involvement (no synchronous ovarian tumor or metastases, no suspicious retroperitoneal nodes).	Dilatation and curettage may be better than office endometrial biopsy. MRI may be the preferred modality compared to ultrasonography and CT to evaluate the presence of myometrial invasion.	Strong desire for fertility sparing. No contraindications for medical management. Patient understands and accepts that data on cancer-related and pregnancy-related outcomes are limited (informed consent).
British Gynaecological Cancer Society (BGCS) Uterine Cancer guidelines [14]	Selected women with grade 1 endometrial cancer.	No invasion or superficial myometrial invasion.	MRI imaging to exclude >50% myometrial invasion, adnexal or nodal involvement.	Specialist gynae-pathology multidisciplinary team review is required. Women should be counseled carefully about the current known response rates on progestins and progression risk. Women should be offered genetic counseling to exclude the presence of Lynch syndrome.