Home > Journals > Minerva Obstetrics and Gynecology > Past Issues > Articles online first > Minerva Obstetrics and Gynecology 2022 Feb 02

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

 

Minerva Obstetrics and Gynecology 2022 Feb 02

DOI: 10.23736/S2724-606X.22.04977-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Laparoscopic stripping versus endometrioma ethanol sclerotherapy in women with endometrioma awaiting IVF: a long-term analysis of ovarian reserve and pregnancy outcome

Domenico ANTONACI 1, Michele C. SCHIAVI 2, Valerio CARLETTI 2, 3 , Veronica YACOUB 2, 3, Claudia MORGANI 2, 3, Debora GRILLI 2, 3, Francesco GALANTI 1, 3, Azzurra LIGATO 2, 3, Herbert C. VALENSISE 3, 4, Pierluigi PALAZZETTI 2, Rocco RAGO 1

1 Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy; 2 Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy; 3 Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy; 4 Department of Obstetrics and Gynecology, Casilino Hospital, Rome, Italy


PDF


AIMS: The aim of this study was to compare ovarian reserve, oocytes quality and pregnancy outcome of endometrioma treatment by Laparoscopic stripping (LS) versus endometrioma ethanol sclerotherapy (EST) in infertile women awaiting in vitro fertilization (IVF).
METHODS: Retrospective analysis was performed. Twenty-three women underwent EST and 26 women LS. Intra- and postoperative complications were recorded. The women were followed up for 36 months for cyst recurrence, oocytes quality and pregnancy outcome. Serum Anti-Mullerian hormone (AMH) levels after treatment were measured to observe the impact on the ovarian reserve. Women’s satisfaction was investigated with PGI-I.
RESULTS: During follow-up, there were 3 endometriomas recurrences after LS and none after EST. Six months after treatment AMH was 3.17±2.15 in EST vs 2.22±1.97 in LS, p=0.045. Symptoms’ improvement was comparable. No intraoperative complications occurred. In the LS group the postoperative complications were significantly higher. After IVF cycles, the quality of the retrieved oocytes was the same. In EST group, clinical pregnancy (48.1% vs 19.6%) and live birth rates (36.5% vs 14.3%) were significantly increased compared to LS. Women’s satisfaction was comparable at PGI-I. Both EST and the presence of an endometrioma sized 6 cm or less proved to be independent factors of a better live birth rate in multivariate analysis.
CONCLUSIONS: EST efficacy was greater than LS for endometrioma. Ovarian function was well preserved. Hospital stay was shorter, fewer complications occurred. Pregnancy outcome was better after EST.


KEY WORDS: Endometriosis; Endometrioma; Laparoscopic stripping; Sclerotherapy

top of page