Therapeutic Efficacy of Catheter-directed Ethanol Sclerotherapy and Its Impact on Ovarian Reserve in Patients with Ovarian Endometrioma at Risk of Decreased Ovarian Reserve: A Preliminary Study

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: Retrospective study. Setting: Teaching hospital. Patients: We evaluated 18 patients with ovarian endometrioma measuring >= 3 cm and preprocedural serum antim_ullerian hormone (AMH) levels of <2 ng/mL. Interventions: An 8.5-F catheter was inserted either transabdominally or transvaginally into the endometrioma. After aspiration, sclerotherapy with 99% ethanol was performed, with a subsequent 20-minute ethanol retention. Measurements and Main Results: Ultrasonography was performed preprocedurally and 6 months after CDS to evaluate any recurrence or changes in cyst size. Furthermore, serum AMH levels, cancer antigen 125 (CA-125) levels, and the visual analog scale scores for dysmenorrhea were obtained to analyze the ovarian reserve and treatment efficacy, preprocedurally and at 6 months after CDS. The mean cyst size on ultrasonography and serum CA-125 levels decreased 6 months after CDS (p <. 001 and p =.001, respectively). All patients reported a decreased visual analog scale 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. (C) 2021 AAGL. All rights reserved.