Volume 11, Issue 3 (5-2013)                   IJRM 2013, 11(3): 179-0 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Aflatoonian A, Rahmani E, Rahsepar M. Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: A randomized Clinical Trial. IJRM 2013; 11 (3) :179-0
URL: http://ijrm.ir/article-1-392-en.html
Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: A randomized Clinical Trial
Abass Aflatoonian1 , Elham Rahmani * 2, Mozhgan Rahsepar1
1- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Obstetrics and Gynecology, Bushehr University of Medical Sciences, Bushehr, Iran , rahmani@bpums.ac.ir
Abstract:   (4545 Views)
Background: 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.
Objective: The study was designed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma.
Materials and Methods: 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.
Results: 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.
Conclusion: Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF.
Keywords: Endometrioma, Ethanol sclerotherapy, Fertilization In-vitro.
Full-Text [PDF 323 kb]   (660 Downloads) |   |   Full-Text (HTML)  (366 Views)  
Type of Study: Original Article |
References
1. Benaglia L, Somigliana E, Vighi V, Nicolosi AE, Iemmello R, Ragni G. Is the dimension of ovarian endometriomas significantly modified by IVF–ICSI cycles? Reprod Biomed Online 2009; 18: 401-406.
2. Bedaiwy MA. Evidence-based long-term management of endometriosis: Medical therapy and treatment of infertility. Middle East Fertil Soc J 2011; 16: 236-239. [DOI:10.1016/j.mefs.2011.06.001]
3. Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility. Fertil Steril 2006; 86: 156-160.
4. Tsoumpou I, Kyrgiou M, Gelbaya TA, Nardo LG. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil Steril 2009; 92: 75-87. [DOI:10.1016/j.fertnstert.2008.05.049]
5. Senapati S, Barnhart K. Managing Endometriosis-associated Infertility. Clin Obstet Gynecol 2011; 54: 720-726. [DOI:10.1097/GRF.0b013e3182353e06]
6. Zhu W, Tan Z, Fu Z, Li X, Chen X, Zhou Y. Repeat transvaginal ultrasound-guided aspiration of ovarian endometrioma in infertile women with endometriosis. Am J Obstet Gynecol 2011; 204: 61. e1-6.
7. Kars B, Buyukbayrak EE, Karsidag AYK, Pirimoglu M, Unal O, Turan C. Comparison of success rates of 'transvaginal aspiration and tetracycline sclerotherapy' versus 'only aspiration' in the management of non-neoplastic ovarian cysts. J Obstet Gynaecol Res 2012; 38: 65-69. [DOI:10.1111/j.1447-0756.2011.01627.x]
8. Hsieh CL, Shiau CS, Lo LM, Hsieh TT, Chang MY. Effectiveness of ultrasound-guided aspiration and sclerotherapy with 95% ethanol for treatment of recurrent ovarian endometriomas. Fertil Steril 2009; 91: 2709-2713. [DOI:10.1016/j.fertnstert.2008.03.056]
9. Yazbeck C, Madelenat P, Ayel JP, Jacquesson L, Bontoux LM, Solal P, et al. Ethanol sclerotherapy: a treatment option for ovarian endometriomas before ovarian stimulation. Reprod Biomed Online 2009; 19: 121-125. [DOI:10.1016/S1472-6483(10)60055-7]
10. André GM, Vilarino FL, Christofolini DM, Bianco B, Barbosa CP. Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization-a pilot study. Einstein 2011; 9: 494-498. [DOI:10.1590/s1679-45082011ao2081]
11. Kafali H, Eser A, Duvan CI, Keskin E, Onaran YA. Recurrence of ovarian cyst after sclerotherapy. Minerva Ginecol 2011; 63: 19-24.
12. Aflatoonian A, Aflatoonian R, Khashavi Z. Comparison between Transvaginal Sonography and Cytological results for detection of ovarian cysts. Iran J Reprod Med 2003; 1: 16-19.
13. Kafali H, Yurtseven S, Atmaca F, Ozardali I. Management of non-neoplastic ovarian cysts with sclerotherapy. Int J Gynaecol Obstet 2003; 81: 41-45. [DOI:10.1016/S0020-7292(02)00401-0]
14. Kumbak B, Kahraman S. Management of prestimulation ovarian cysts during assisted reproductive treatments: impact of aspiration on the outcome. Arch Gynecol Obstet 2009; 279: 875-880. [DOI:10.1007/s00404-008-0837-7]
15. Wang LL, Dong XQ, Shao XH, Wang SM. Ultrasound-Guided Interventional Therapy for Recurrent Ovarian Chocolate Cysts. Ultrasound Med Biol 2011; 37: 1596-1602. [DOI:10.1016/j.ultrasmedbio.2011.07.004]
16. Ikuta A, Tanaka Y, Mizokami T, Tsutsumi A, Sato M, Tanaka M, et al. Management of transvaginal ultrasound-guided absolute ethanol sclerotherapy for ovarian endometriotic cysts. J Med Ultrason 2006; 33: 99-103. [DOI:10.1007/s10396-005-0079-2]
17. Koike T, Minakami H, Motoyama M, Ogawa S, Fujiwara H, Sato I. Reproductive performance after ultrasound-guided transvaginal ethanol sclerotherapy for ovarian endometriotic cysts. Eur J Obstet Gynecol Reprod Biol 2002; 105: 39-43. [DOI:10.1016/S0301-2115(02)00144-6]
18. Noma J, Yoshida N. Efficacy of ethanol sclerotherapy for ovarian endometriomas. Int J Gynecol Obstet 2001; 72: 35-39. [DOI:10.1016/S0020-7292(00)00307-6]
19. Salem HA, Soliman AT, Moustafa MZ, Abd Al-Naby EA, Ajlan DM, Alghorab NM. US guided aspiration and 95% ethanol sclerotherapy of ovarian endometrioma before IVF/ICSI. Fertil Steril 2011; 96: S173.
20. Reinblatt SL, Ishai L, Shehata F, Son WY, Tulandi T, Almog B. Effects of ovarian endometrioma on embryo quality. Fertil Steril 2011; 95: 2700-2702. [DOI:10.1016/j.fertnstert.2011.03.002]
21. Okagaki R, Osuga Y, Momoeda M, Tsutsumi O, Taketani Y. Laparoscopic findings after ultrasound-guided transvaginal ethanol sclerotherapy for ovarian endometrial cyst. Hum Reprod 1999; 14: 270. [DOI:10.1093/humrep/14.1.270]
22. Rodriguez-Panadero F, Antony VB. Pleurodesis: state of the art. Eur Respir J 1997; 10: 1648-1654. [DOI:10.1183/09031936.97.10071648]
23. Chang CC, Lee HF, Tsai HD, Lo HY. Sclerotherapy--an adjuvant therapy to endometriosis. Int J Gynecol Obstet 1997; 59: 31-34. [DOI:10.1016/S0020-7292(97)00122-7]
24. Molloy D, Martin M, Speirs A, Lopata A, Clarke G, McBain J, et al. Performance of patients with a" frozen pelvis" in an in vitro fertilization program. Fertil Steril 1987; 47: 450-455. [DOI:10.1016/S0015-0282(16)59054-2]
25. Ishihara H, Kitawaki J, Kado N, Koshiba H, Fushiki S, Honjo H. Gonadotropin-releasing hormone agonist and danazol normalize aromatase cytochrome P450 expression in eutopic endometrium from women with endometriosis, adenomyosis, or leiomyomas. Fertil Steril 2003; 79: 735-742. [DOI:10.1016/S0015-0282(02)04813-6]
26. Wu HH, Wang NM, Lin CY, Tsai HD. Genetic alterations of HOXA10 and their effect on the severity of endometriosis in a Taiwanese population. Reprod Biomed Online 2008; 16: 416-424. [DOI:10.1016/S1472-6483(10)60604-9]
27. Wei Q, St Clair JB, Fu T, Stratton P, Nieman LK. Reduced expression of biomarkers associated with the implantation window in women with endometriosis. Fertil Steril 2009; 91: 1686-1691. [DOI:10.1016/j.fertnstert.2008.02.121]
28. Somigliana E, Vercellini P, Daguati R, Giambattista E, Benaglia L, Fedele L. Effect of delaying post-operative conception after conservative surgery for endometriosis. Reprod Biomed Online 2010; 20: 410-415. [DOI:10.1016/j.rbmo.2009.12.010]
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb