Effect of catheter-directed ethanol sclerotherapy on ovarian reserve in patients with recurrent endometrioma: comparative analysis with primary endometriosis

Jae Kyung Lee, Kichang Han, Euna Choi, Jinkyung Baek, Hae‐Rim Kim, Hae-Rim Kim, Man Deuk Kim, Man-Deuk Kim, Heeyon Kim, Seok Kyo Seo
European radiology · 2023 · vol. 34(5) , pp. 3298–3308 · doi:10.1007/s00330-023-10320-z · PMID:37848771 · W4387697381
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

Catheter-directed ethanol sclerotherapy showed no significant difference in anti-Müllerian hormone levels for recurrent endometrioma compared to primary endometrioma.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective, single-institution observational study evaluated changes in ovarian reserve, measured by anti-Müllerian hormone (AMH), in adults with recurrent ovarian endometrioma undergoing catheter-directed ethanol sclerotherapy (CDS), comparing them with patients with primary endometrioma. AMH and other baseline variables (including cyst diameter and CA-125) were assessed before CDS and at multiple follow-up times (1 month through 3 years), with outcomes analyzed both overall and stratified by laterality, baseline AMH, and initial cyst size. The study found no significant difference in AMH levels between primary and recurrent groups at baseline and no significant difference in the delta change in AMH at any follow-up time, with no recurrences reported in either group. The paper’s main limitation, as framed by its methods, is that it is retrospective and observational without randomization. This paper is centrally about endometriosis — it directly examines ovarian reserve changes after CDS specifically in recurrent versus primary endometrioma.

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Abstract

OBJECTIVE: Catheter-directed ethanol sclerotherapy (CDS) is known to less affect the ovarian function, with comparable efficacy. This study aims to investigate the change in ovarian reserve after catheter-directed ethanol sclerotherapy in patients with recurrent endometrioma, as compared to primary endometrioma. MATERIALS AND METHODS: Retrospective, observational study. Electronic medical records and images of patients with endometrioma who underwent CDS from August 2014 to April 2022 at a single institution were obtained. Patients aged > 18 years old and with anti-Müllerian hormone (AMH) level between 0.8 and 10.0 with regular menstruation were enrolled. Cyst diameter, laterality, AMH level, and CA-125 level before and after 1 month, 6 months, 1 year, 2 years, and 3 years of sclerotherapy were obtained. RESULTS: A total of 180 patients were fit for analysis. There was no statistical difference in age and cyst size between the two groups. Mean values of AMH in each group were 3.35 in the primary group and 3.00 in the recurrent group prior to the procedure (p = 0.347). There was no significant difference in delta value of AMH after sclerotherapy in both groups at each follow-up period. Also, this result was consistent when stratified by laterality, preprocedural AMH level, and initial size of endometrioma. No case of recurrence was reported in both groups. CONCLUSIONS: The effect of CDS on ovarian reserve is not inferior in recurrent endometrioma compared to primary endometrioma. Since sclerotherapy is known to less deteriorate the ovarian function than surgical removal of endometrioma, clinician could consider this as the first-line therapy in patients with recurrent endometrioma. CLINICAL RELEVANCE STATEMENT: Catheter-directed ethanol sclerotherapy for patients with recurrent endometrioma has similar effect on ovarian reserve compared to patients with primary endometrioma. KEY POINTS: • Secondary surgery for endometrioma has significant deleterious effect on ovarian function. • Catheter-directed sclerotherapy (CDS) for endometrioma had equally minimal adverse effect on ovarian reserve, represented as anti-Müllerian hormone (AMH), in both primary and recurrent groups. • Physicians should consider CDS for patients with recurrent endometrioma who desire to preserve ovarian function.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Ethanol Ethanol Ethanol Ethanol Ethanol Ethanol Ethanol Ethanol Ethanol Ethanol

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