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Assisted Reproductive Technology Outcomes After Ethanol Sclerotherapy in Poor Responder Patients With Endometriomas: A Before-After Clinical Trial Publisher



Ghasemi F1 ; Kashani L1 ; Moini A2, 3, 4 ; Mojtahedi MF1 ; Shahhosseini R1 ; Alemohammad F1
Authors
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Authors Affiliations
  1. 1. Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  4. 4. Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Reproduction and Infertility Published:2024


Abstract

Background: The purpose of the present study was to investigate the assisted reproductive technology (ART) outcomes after ethanol sclerotherapy (EST) in poor responder patients with endometriomas. Methods: In this before-after clinical trial, the outcomes of ART of 31 poor responders with endometriomas were evaluated after EST between July 2023 to March 2024. These patients had undergone ART at least in one cycle before and did not respond well. Recurrence rate, antral follicle count (AFC), anti-Mullerian hormone (AMH), and relief of symptoms including dysmenorrhea and abnormal uterine bleeding (AUB) were evaluated before the procedure. Follow-up assessments were conducted two and six weeks after the procedure for evaluating the complications. Fisher’s exact test, chi-square test, and paired sample t-test were used for statistical analysis using SPSS 24. Results: In this study, the levels of AFC and AMH increased significantly after endometrioma stripping therapy (p<0.05). Additionally, the number of embryos obtained increased significantly, indicating potential improvement in oocyte quality. There was a significant reduction in pelvic pain scores (p=0.001), as well as a notable decrease in dysmenorrhea (p=0.02) and dyspareunia (p=0.001). Moreover, 16.12% of patients reported recovery from intermenstrual bleeding. However, no significant difference was observed in the amount of gonadotropin used (p=0.56). Conclusion: EST is an appropriate and safe procedure before ART for poor responders who have endometriomas and can be a replacement for surgery among selected patients. Copyright © 2024, Journal of Reproduction & Infertility.
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1. Efficacy of Ethanol Sclerotherapy Versus Laparoscopic Excision in the Treatment of Ovarian Endometrioma, Journal of Obstetrics and Gynecology of India (2024)
2. Risk Factors for Anti Mullerian Hormone Decline After Laparoscopic Excision of Endometrioma: A Prospective Study, International Journal of Fertility and Sterility (2022)
3. Comparing Ovarian Reserve After Laparoscopic Excision of Endometriotic Cysts and Hemostasis Achieved Either by Bipolar Coagulation or Suturing: A Randomized Clinical Trial, Archives of Gynecology and Obstetrics (2016)
4. The Impact of Laparoscopic Cystectomy on Ovarian Reserve in Patients With Unilateral and Bilateral Endometrioma, International Journal of Gynecology and Obstetrics (2017)
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