ART outcomes in endometrioma patients undergoing sclerotherapy versus laparoscopic cystectomy: A clinical trial

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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RMED08_005

تاریخ نمایه سازی: 21 مرداد 1398

Abstract:

Background: Endometriosis is a common, chronic gynecologic condition associated with pelvic pain and infertility. Moderate to severe disease including endometrioma appears to negatively impact ART outcomes. Laparoscopic ovarian cystectomy is the treatment of choice, but it would result in reduction of ovarian reserve. Thus a less invasive procedure like ethanol sclerotherapy has been proposed before ART, but this technique may be associated with higher recurrence rate.Objective: In this study ART outcomes and recurrence rate after these two procedures in endometrioma patients are compared.Materials and Methods: One hundred and sixteen infertile patients with endometrioma referring to two private and university hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran participated in this study. The patients were divided by simple random allocation in two groups. The first group underwent ART after one year of unsuccessful spontaneous pregnancy following laparoscopic ovarian cystectomy, and the second group had ethanol sclerotherapy following oocyte retrieval. Number of oocytes, cumulative pregnancy rate, and recurrence rate of endometrioma were evaluated.Results: Thirty patients were analyzed in the laparoscopic cystectomy group and 34 in sclerotherapy group. Fourteen patients had been excluded (not meeting inclusion criteria; n=8, no oocytes; n=6), 9 had no embryos, and 18 lost to follow-up, 11 did not return for embryo transfer in the study period. Cumulative pregnancy rate was higher in the first (33.3%) than the second group (29.4%), but it was not statistically significant (p=0.95). The rate of recurrence was 10.7% in the first group, and 16.7% in the second group, which was not statistically significant (p=0.51).Conclusion: No significant differences were detected in ART outcomes and recurrence rate comparing laparoscopic cystectomy and sclerotherapy of endometriomas.

Authors

S Alborzi

Division of Infertility and Gynecologic Endoscopy, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Sh Moradi Alamdarloo

Division of Infertility and Gynecologic Endoscopy, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

T Poordast

Division of Infertility and Gynecologic Endoscopy, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

P Keramati

Division of Infertility and Gynecologic Endoscopy, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran