No Invasive Carcinoma Identified in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#12117
SMLE Question #12117
Obstetrics & Gynecology
General Gynecology
Objective: OBJ-ETH-STERIL
Last updated: February 2026
A 25-year-old nulliparous woman has 6 months of irregular heavy menstrual bleeding and intermenstrual spotting. She has obesity (BMI 34 kg/m²) and chronic anovulation. Pelvic examination is unremarkable and a pregnancy test is negative. Transvaginal ultrasound shows a thickened endometrium. Office endometrial biopsy shows endometrial intraepithelial neoplasia (atypical hyperplasia) with no invasive carcinoma identified. She strongly desires future fertility. What is the most appropriate management at this time?
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