Ethanol Sclerotherapy versus Laparoscopic Surgery for Endometrioma Treatment: A Prospective, Multicenter, Cohort Pilot Study

García‐Tejedor, Amparo; Martínez-García, José Manuel; Candas, Beatriz; Suarez, Elena; Mañalich, L.; Gómez, Marta Pernas; Merino, Elisabet; Castellarnau, Marta; Regueiro, Purificacion; Carreras, Manuel; Franco, Eva Martínez; Carrarrach, Marta; Subirats, Neus; Barbera, Judith; González, Santiago; Climent, Maite; Fernández-Montolí, Eulalia; Ponce, Jordi

doi:10.1016/j.jmig.2019.08.036

Cited by 25 publications

(19 citation statements)

References 27 publications

(27 reference statements)

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“…Here, it should be noted that in this study with a maximum follow‐up of 20 months, the number of patients with bilateral endometrioma in the surgical group was significantly higher than the sclerotherapy group from the beginning of the study ( P = .004), which could explain the difference in recurrence rate between two groups. Also, the occurrence of pregnancy in the sclerotherapy group (three out of 17 cases) may justify less recurrence rate of disease in this group than in the surgical group 54 …”

Section: Discussionmentioning

confidence: 92%

Assisted reproductive technique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy: Prospective cross‐sectional study

Alborzi

Askary

Keramati

et al. 2021

Reprod Medicine & Biology

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Purpose The authors compared assisted reproductive technique (ART) outcomes and the recurrence rate of endometrioma in the infertile patients undergoing sclerotherapy vs laparoscopic ovarian cystectomy. Methods In this prospective cross‐sectional study, a total of 101 infertile patients, with unilateral endometriomas, were divided into two groups. The first group (n = 57) underwent ART after 1 year of unsuccessful spontaneous pregnancy after laparoscopic ovarian cystectomy; the second group (n = 44) had ethanol sclerotherapy (EST) at the time of oocyte retrieval. The authors measured the number of oocytes, clinical pregnancy rate (CPR), live birth rate (LBR), complication, and recurrence of endometriomas as the primary and secondary outcomes. Results The two groups had no significant differences in baseline characteristics and ovarian stimulation markers and also total number of oocytes. 42.1% and 34.1% of the patients (n = 24 and 15) had clinical pregnancy, and 38.6% and 29.5% (n = 22 and 13) had live birth following ART cycles in the surgery group and sclerotherapy group (P = .41, 0.34). The recurrence rates were 14.0% and 34.1% in the surgery and sclerotherapy groups (P = .017, X2 = 5.67). Conclusions Ethanol sclerotherapy can be a good alternative to surgery concerning the treatment of endometrioma; however, the recurrence of the disease in this group is significantly higher.

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Section: Discussionmentioning

confidence: 92%

Assisted reproductive technique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy: Prospective cross‐sectional study

Alborzi

Askary

Keramati

et al. 2021

Reprod Medicine & Biology

View full text Add to dashboard Cite

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“…One of the 17 patients who underwent sclerotherapy had recurrence (5.9%) compared with 4 of 14 patients who underwent laparoscopic surgery. Ethanol sclerotherapy was clearly more cost-effective with median hospital direct costs significantly lower in the sclerotherapy group than in the surgery group (266 Euros versus 2,189 Euros) (5).…”

mentioning

confidence: 87%

“…By producing a controlled inflammatory response, ethanol sclerotherapy leads to fibroblast proliferation, cellular dehydration, and ultimately fibrinoid necrosis of the cyst wall. Its proposed advantages include minimizing ovarian trauma while preventing injury and removal of healthy ovarian tissue and follicles (2,5). For those who are interested in performing ethanol sclerotherapy, this video abstract is an excellent primer because the authors describe the technique in an easy to understand format.…”

mentioning

confidence: 99%

Ethanol sclerotherapy for endometriomas: ready for prime time?

Nasab

Bedrick

Christianson

2021

Fertility and Sterility

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“…However, in our experience, we have gradually increased the size of endometriomas eligible for sclerotherapy from 65 to 100 mm in diameter. A recent study also reports the successful sclerotherapy of endometriomas up to 100 mm [51]. It would be interesting to study IVF live birth rates after EST of cysts measuring 65 to 100 mm.…”

Section: Plos Onementioning

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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Ethanol Sclerotherapy versus Laparoscopic Surgery for Endometrioma Treatment: A Prospective, Multicenter, Cohort Pilot Study

Cited by 25 publications

References 27 publications

Assisted reproductive technique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy: Prospective cross‐sectional study

Assisted reproductive technique outcomes in patients with endometrioma undergoing sclerotherapy vs laparoscopic cystectomy: Prospective cross‐sectional study

Ethanol sclerotherapy for endometriomas: ready for prime time?

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

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