Aflatoonian Abbas, Tabibnejad Nasim
Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Int J Reprod Biomed. 2020 Nov 22;18(11):935-942. doi: 10.18502/ijrm.v13i11.7960. eCollection 2020 Nov.
Endometrioma is a common high-recurrence gynecological disease that affects infertility. Surgical resection using laparotomy or laparoscopy is applied as a standard treatment. Moreover, sclerotherapy is reported to be effective as a non-invasive method for treating endometrioma.
To evaluate whether the ethanol retention or aspiration after sclerotherapy improve pregnancy outcome in infertile women with endometrioma.
In a retrospective study, hospital records of 43 women with recurrent or bilateral endometrioma who had been undergone transvaginal ultrasound sclerotherapy were reviewed. They were selected to receive either ethanol for 10 min, ethanol injection, irrigation, and then aspiration or total retention without aspiration based on the surgeon's decision. The participants were followed-up for 3, 6 and 12 months for natural or artificial conception as well as for cyst recurrence.
Chemical pregnancy was positive in 52% of the women in the aspiration group and 53.8% in the retention group. Ongoing pregnancy (44% vs 46.2%, p = 0.584) and live birth (40% vs 46.2%, p = 0.490) were reported marginally higher in the retention group compared with the aspiration group, and the differences were not statistically significant. Moreover, the recurrence rate were found to be 48.1% and 37.5% in the aspiration and retention groups, respectively (p = 0.542). The cysts size in the retention group was significantly correlated to the recurrence rate.
Both the aspiration and left in situ of ethanol 95% sclerotherapy have the similar impact on the treatment of ovarian endometrioma regarding pregnancy and recurrence rate. However, larger randomized studies with strict inclusion criteria are needed.
卵巢巧克力囊肿是一种常见的、复发率高且影响不孕的妇科疾病。采用剖腹手术或腹腔镜手术切除是标准治疗方法。此外，据报道硬化疗法作为一种治疗卵巢巧克力囊肿的非侵入性方法是有效的。
评估硬化疗法后乙醇保留或抽吸是否能改善患有卵巢巧克力囊肿的不孕女性的妊娠结局。
在一项回顾性研究中，查阅了43例复发性或双侧卵巢巧克力囊肿患者经阴道超声硬化疗法的医院记录。根据外科医生的决定，她们被选择接受10分钟乙醇治疗、乙醇注射、冲洗，然后抽吸，或者完全保留不抽吸。对参与者进行3、6和12个月的随访，观察自然受孕或人工受孕情况以及囊肿复发情况。
抽吸组52%的女性化学妊娠呈阳性，保留组为53.8%。保留组的持续妊娠率（44%对46.2%，p = 0.584）和活产率（40%对46.2%，p = 0.490）略高于抽吸组，但差异无统计学意义。此外，抽吸组和保留组的复发率分别为48.1%和37.5%（p = 0.542）。保留组的囊肿大小与复发率显著相关。
95%乙醇硬化疗法的抽吸和原位保留在妊娠和复发率方面对卵巢巧克力囊肿的治疗有相似影响。然而，需要进行纳入标准严格的更大规模随机研究。
