Aflatoonian Abass, Rahmani Elham, Rahsepar Mozhgan
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Obstetrics and Gynecology, Bushehr University of Medical Sciences, Bushehr, Iran.
Iran J Reprod Med. 2013 Mar;11(3):179-84.
Endometriosis is a common hormone-dependent gynecologic disease with a high recurrence. Laparotomy or laparoscopy is the standard surgery for the large endometrioma. Also, sclerotherapy is basically used to treat different diseases one of which is endometrioma.
The study was designed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma.
In a randomized clinical trial, an interventional group of 20 patients underwent transvaginal ethanol sclerotherapy for recurrent ovarian endometrioma. The patients were followed up first after one and two weeks and then after one, two, and three months. If the patients had no endometrioma, they were treated with in vitro fertilization (IVF) (standard long protocol). A control group of 20 patients with endometrioma were enrolled for an IVF protocol. They had no treatment by ethanol sclerotherapy. IVF parameters, pregnancy rates, and implantation rates were compared in both groups.
The demographic data showed no difference between the two groups. The initial mean endometria size was 41.45±15.9 cm, the recurrence rate after 6 months was 4 (20%), FSH before and after sclerotherapy was 6.97±2.25 IU/L and 6.78±1.88 IU/L (p=0.343). The clinical pregnancy rate was 6 (33.3%) vs. 3 (15%), (p=0.616). The fertilization rate emerged 63.06% in study group vs. 60.38%, (p=0.57). The implantation rate turned out 12.9% in study group vs. 7.5%, (p=0.52). None of these results were significant. However, the data pointed to a better trend toward the ethanol sclerotherapy group.
Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF.
子宫内膜异位症是一种常见的激素依赖性妇科疾病，复发率高。剖腹手术或腹腔镜手术是治疗大型子宫内膜瘤的标准手术。此外，硬化疗法主要用于治疗多种疾病，其中之一是子宫内膜瘤。
本研究旨在评估经阴道超声引导下乙醇硬化疗法对复发性子宫内膜瘤患者的价值。
在一项随机临床试验中，20例患者组成的干预组接受经阴道乙醇硬化疗法治疗复发性卵巢子宫内膜瘤。患者在术后第1周和第2周进行首次随访，然后在第1、2和3个月进行随访。如果患者没有子宫内膜瘤，则采用体外受精（IVF）（标准长方案）进行治疗。20例患有子宫内膜瘤的患者组成对照组，采用IVF方案。他们未接受乙醇硬化疗法治疗。比较两组的IVF参数、妊娠率和着床率。
人口统计学数据显示两组之间无差异。初始平均子宫内膜大小为41.45±15.9 cm，6个月后的复发率为4例（20%），硬化疗法前后的促卵泡激素分别为6.97±2.25 IU/L和6.78±1.88 IU/L（p = 0.343）。临床妊娠率为6例（33.3%）对3例（15%），（p = 0.616）。研究组的受精率为63.06%，对照组为60.38%，（p = 0.57）。研究组的着床率为12.9%，对照组为7.5%，（p = 0.52）。这些结果均无统计学意义。然而，数据表明乙醇硬化疗法组有更好的趋势。
乙醇硬化疗法可能是治疗复发性子宫内膜瘤的有效策略，尤其是在IVF之前。
