Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

Andre, G.; Vilariño, Fabia Lima; Christofolini, Denise Maria; Bianco, Bianca; Barbosa, Caio Parente

doi:10.1590/s1679-45082011ao2081

Cited by 13 publications

(22 citation statements)

References 30 publications

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“…Finally, therefore, 18 studies were included in the present review. Supplemental Tables 1 and 2 show study characteristics and risk of bias (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

Section: Literature Identificationmentioning

confidence: 99%

“…Sclerotherapy was performed transvaginally (13 studies), transabdominally (one study), or both (three studies). In women who were treated with the use of ethanol sclerotherapy, 11 studies used the ethanol ''washing'' technique (ethanol was instilled for 0-15 minutes and then removed) (13,15,16, 20, 21 24, 26, 28, 29), and in four studies the ethanol was left in situ (14,17,19,22). The volume of ethanol instillation ranged from 50% to 100% of the initial aspirated cyst volume.…”

Section: Reported Interventions During Endometrioma Sclerotherapymentioning

confidence: 99%

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Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis

Cohen

Almog

Tulandi

2017

Fertility and Sterility

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Section: Literature Identificationmentioning

confidence: 99%

Section: Reported Interventions During Endometrioma Sclerotherapymentioning

confidence: 99%

Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis

Cohen

Almog

Tulandi

2017

Fertility and Sterility

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“…It has been shown previously that a larger cyst diameter is significantly associated with recurrence (31) and that women with cyst size ≤ 5 cm experience a higher recovery rate (23). Additionally, Andre and colleagues stated that ovarian cysts with a mean diameter of 4.7 cm did not recur after aspiration (26). It is confirmed that larger cysts have thick multiple septa and several cavities and hold more pathologic fillings; therefore, a larger area of endothelial lining is involved during the manipulation of these cysts.…”

Section: Discussionmentioning

confidence: 97%

“…Ethanol sclerotherapy is a good alternative policy to avoid detrimental effects of laparoscopic cystectomy on ovarian function (18,25). Andre and colleagues et al reported a 20% pregnancy rate after ethanol sclerotherapy of ovarian endometrioma subsequent to ovarian stimulation with GnRh agonist protocol (26). In our previous clinical trial, we enrolled 40 women with recurrent endometrioma for an IVF cycle; 20 patients randomly underwent International Journal of Reproductive BioMedicine Ethanol sclerotherapy and endometrioma ethanol sclerotherapy.…”

Section: Discussionmentioning

confidence: 99%

Aspiration versus retention ultrasound-guided ethanol sclerotherapy for treating endometrioma: A retrospective cross-sectional study

Aflatoonian

Tabibnejad

2020

IJRM

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Background: Endometrioma is a common high-recurrence gynecological disease that affects infertility. Surgical resection using laparotomy or laparoscopy is applied as a standard treatment. Moreover, sclerotherapy is reported to be effective as a noninvasive method for treating endometrioma. Objective: To evaluate whether the ethanol retention or aspiration after sclerotherapy improve pregnancy outcome in infertile women with endometrioma. Materials and Methods: In a retrospective study, hospital records of 43 women with recurrent or bilateral endometrioma who had been undergone transvaginal ultrasound sclerotherapy were reviewed. They were selected to receive either ethanol for 10 min, ethanol injection, irrigation, and then aspiration or total retention without aspiration based on the surgeon’s decision. The participants were followed-up for 3, 6 and 12 months for natural or artificial conception as well as for cyst recurrence. Results: Chemical pregnancy was positive in 52% of the women in the aspiration group and 53.8% in the retention group. Ongoing pregnancy (44% vs 46.2%, p = 0.584) and live birth (40% vs 46.2%, p = 0.490) were reported marginally higher in the retention group compared with the aspiration group, and the differences were not statistically significant. Moreover, the recurrence rate were found to be 48.1% and 37.5% in the aspiration and retention groups, respectively (p = 0.542). The cysts size in the retention group was significantly correlated to the recurrence rate. Conclusion: Both the aspiration and left in situ of ethanol 95% sclerotherapy have the similar impact on the treatment of ovarian endometrioma regarding pregnancy and recurrence rate. However, larger randomized studies with strict inclusion criteria are needed. Key words: Endometrioma, Ethanol, Sclerotherapy, In vitro fertilization, Pregnancy rate.

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“…There are few studies, and the results are contradictory. Some studies demonstrated a benefit [ 20 , 22 , 29 – 31 ], whereas others did not show any significant improvement. Currently, the role of EST in the management of endometriomas is not well defined as demonstrated by the meta-analysis of Cohen et al [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis

et al. 2020

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Objective To examine the impact of ethanol sclerotherapy (EST) for endometrioma on in vitro fertilization (IVF) cumulative live birth rates (CLBR) in women with moderate-severe endometriosis. Methods This retrospective cohort study included women with moderate-severe endometriosis (revised American Fertility Society stage III-IV) and endometrioma who underwent IVF with the ultra-long agonist protocol. We compared two groups: women undergoing EST for endometrioma before IVF (EST group), and women whose endometrioma was left in situ during IVF (No-EST group). The primary outcome was the CLBR per IVF cycle, including fresh and frozen embryo transfers. The secondary endpoints included the complication rate, number of mature oocytes retrieved, clinical pregnancy rate and pregnancy loss rate. Results Seventy-four women were included in the study, with 37 in the EST group and 37 in the No-EST group, representing 67 and 69 IVF cycles, respectively. The population and cycle characteristics were comparable between the two groups, especially the ovarian response to stimulation. The CLBR was significantly increased in the EST group compared to the No-EST group (31.3% vs. 14.5%, p = 0.03). The clinical and biochemical pregnancy rates were significantly increased in the EST group (37.3% vs. 15.9%, p = 0.01 and 43.3% vs. 23.2%, p = 0.01, respectively). Multivariate analysis revealed a significantly increased chance of live birth in women exposed to EST before IVF with an adjusted OR of 2.68 (95% confidence interval, CI: 1.13-6.36, p = 0.02). In the EST group, we reported one major complication Clavien and Dindo classification grade III, complication involving an ovarian abscess that required a laparoscopic drainage.

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Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization – a pilot study

Cited by 13 publications

References 30 publications

Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis

Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis

Aspiration versus retention ultrasound-guided ethanol sclerotherapy for treating endometrioma: A retrospective cross-sectional study

Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis

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