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

• Published in: Einstein (São Paulo, Brazil) Brazil), 2011-12, Vol.9 (4), p.494-498
• Main Authors: Gustavo Mendonça André, Fábia Lima Vilarino, Denise Maria Christofolini, Bianca Bianco, Caio Parente Barbosa
• Format: Article
• Language: English
• Subjects: Endometriosis; In vitro fertilization; Infertility; Reproductive techniques; Sclerotherapy
• ISSN: 1679-4508

Objective: To describe the evolution of controlled ovarian hyperstimulation in women with recurrent ovarian endometriomas treated with sclerotherapy. Methods: Twenty-one patients with a laparoscopic diagnosis of stage III or IV endometriosis who had an endometrioma larger than 3 cm before ovarian hyperstimulation for in vitro fertilization were included in the study. After using a GnRH agonist analog for at least 20 days, the cysts were punctured using ultrasound guidance and subsequent ethanol sclerotherapy was performed. Then, the patients were stimulated with 100 or 200 U/day of recombinant follicle stimulating hormone, varying the dose according to the patient’s age or history of a previous unilateral oophorectomy. Results: The ovarian cysts had an average diameter of 4.7 ± 1.4 cm and did not recur after aspiration during the ovulation induction. Oocyte extraction occurred after 11 days of hyperstimulation, with 3.95 ± 3.30 oocytes obtained per cycle, on average. Embryo transfer occurred in 71.4% (15/21) of patients, and the pregnancy rate after transfer was 20% (3/15). Conclusion: Aspiration followed by ethanol sclerotherapy prior to in vitro fertilization can be an option for patients who desire a pregnancy and have recurrent endometriomas.