J Minim Invasive Gynecol. 2021 Aug 29:S1553-4650(21)00404-0. doi: 10.1016/j.jmig.2021.08.018. Online ahead of print.
ABSTRACT
STUDY OBJECTIVE: To investigate the therapeutic efficacy of catheter-directed ethanol sclerotherapy (CDS) and its effect on ovarian reserve in patients with endometrioma at risk of decreased ovarian reserve.
DESIGN: A retrospective study.
SETTING: A teaching hospital.
PATIENTS: We evaluated 18 patients with ovarian endometrioma measuring ≥3 cm and pre-procedural serum anti-Müllerian hormone (AMH) levels of <2 ng/mL.
INTERVENTIONS: An 8.5-F catheter was inserted either transabdominally or transvaginally into the endometrioma. Following aspiration, sclerotherapy with 99% ethanol was performed, with subsequent 20-minute ethanol retention.
MEASUREMENTS AND MAIN RESULTS: Ultrasonography (US) was performed pre-procedurally and 6 months following CDS to evaluate any recurrence or changes in cyst size. Further, serum AMH levels, CA-125 levels, and the visual analog scale (VAS) scores for dysmenorrhea were obtained to analyze the ovarian reserve and treatment efficacy, pre-procedurally and at 6 months after CDS. The mean cyst size on US and serum CA-125 levels decreased 6 months after CDS (p < .001, and p = .001, respectively). All patients reported a decreased VAS score for dysmenorrhea (p < .001). However, the difference in serum AMH levels before and after CDS was statistically insignificant (p = .875).
CONCLUSION: CDS was efficacious in reducing pain and serum CA-125 levels in patients with low AMH levels without adversely affecting their ovarian reserve.
PMID:34469826 | DOI:10.1016/j.jmig.2021.08.018
