Impact of Laparoscopic Sclerotherapy for Ovarian Endometriomas on Ovarian Reserve

J Minim Invasive Gynecol. 2023 Jan;30(1):32-38. doi: 10.1016/j.jmig.2022.10.001. Epub 2022 Oct 10.

Abstract

Study: Objective: To evaluate the impact of laparoscopic sclerotherapy on the management of endometrioma during surgery for deep infiltrative endometriosis (DIE).

Design: Observational study.

Setting: Tivoli-Ducos Clinic, Bordeaux.

Patients: Sixty-nine patients underwent laparoscopic sclerotherapy for endometrioma during surgery for DIE.

Interventions: Laparoscopic sclerotherapy with 95% ethanol solution and DIE surgery.

Measurements and main results: Antimüllerian hormone (AMH) levels before and at least 6 months after surgery, recurrences, and pregnancies. Mean AMH (ng/mL) levels were 3.4 (2.3) before surgery and 2 (1.7) after surgery (p <.001). Mean difference was 1.29 ng/mL. Preoperative AMH level was the only variable independently associated with an additive decrease in AMH. Mean (standard deviation) follow-up period was 17.5 months (4.6) (range 9-26 months); 18 of 44 patients (40.1%) with pregnancy intent conceived. Of 51 patients who underwent postoperative pelvic ultrasound, 6 (6 of 51, 11.8%) had a recurrence of endometrioma.

Conclusion: Laparoscopic sclerotherapy for endometrioma >40 mm during surgery for DIE sclerotherapy has a low impact on AMH, preserves fertility, and prevents recurrence.

Keywords: DIE; Endometrioma; Fertility; Laparoscopic sclerotherapy.

Publication types

  • Observational Study

MeSH terms

  • Anti-Mullerian Hormone
  • Endometriosis* / surgery
  • Female
  • Humans
  • Laparoscopy*
  • Ovarian Reserve*
  • Pregnancy
  • Prospective Studies
  • Sclerotherapy

Substances

  • Anti-Mullerian Hormone