Assisted Reproductive Technology Outcomes After Ethanol Sclerotherapy in Poor Responder Patients with Endometriomas: A Before-After Clinical Trial

In: Journal of Reproduction & Infertility · 2024 · vol. 25(3) , pp. 224–230 · doi:10.18502/jri.v25i3.17017 · PMID:39830317 · PMC11736268 · W4404447243
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Ethanol sclerotherapy for endometriomas in poor responders improved antral follicle count, AMH, embryo yield, and pain symptoms before assisted reproductive technology.

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This before-after clinical trial evaluated assisted reproductive technology outcomes in poor responder patients who had endometriomas treated with ethanol sclerotherapy, comparing ART results before versus after the intervention. The study reported the post-sclerotherapy ART outcomes in this specific population, focusing on measures used to characterize treatment performance. A key limitation is the before-after design, which lacks randomization and control for potential temporal or selection effects. This paper is centrally about endometriosis — it examines ART outcomes after ethanol sclerotherapy in poor responder patients with endometriomas.

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Abstract

Background: The purpose of the present study was to investigate the assisted reproductive technology (ART) outcomes after ethanol sclerotherapy (EST) in poor responder patients with endometriomas. Methods: In this before-after clinical trial, the outcomes of ART of 31 poor responders with endometriomas were evaluated after EST between July 2023 to March 2024. These patients had undergone ART at least in one cycle before and did not respond well. Recurrence rate, antral follicle count (AFC), anti-Müllerian hormone (AMH), and relief of symptoms including dysmenorrhea and abnormal uterine bleeding (AUB) were evaluated before the procedure. Follow-up assessments were conducted two and six weeks after the procedure for evaluating the complications. Fisher's exact test, chi-square test, and paired sample t-test were used for statistical analysis using SPSS 24. Results: In this study, the levels of AFC and AMH increased significantly after endometrioma stripping therapy (p<0.05). Additionally, the number of embryos obtained increased significantly, indicating potential improvement in oocyte quality. There was a significant reduction in pelvic pain scores (p=0.001), as well as a notable decrease in dysmenorrhea (p=0.02) and dyspareunia (p=0.001). Moreover, 16.12% of patients reported recovery from intermenstrual bleeding. However, no significant difference was observed in the amount of gonadotropin used (p=0.56). Conclusion: EST is an appropriate and safe procedure before ART for poor responders who have endometriomas and can be a replacement for surgery among selected patients.
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Publication Journal of Reproduction & Infertility Record type Journal article Published 17 November 2024 Authors Farah Ghasemi | Ladan Kashani | Ashraf Moini | Maryam Farid Mojtahedi | Roza Shahhosseini | Farzaneh Alemohammad The publisher of this work supports multiple resolution. The work is available from the following locations: {'doi': '10.18502/jri.v25i3.17017', 'member_id': '7770', 'member': 'Knowledge E DMCC', 'container-title': 'Journal of Reproduction & Infertility', 'primary-resource': 'https://publish.kne-publishing.com/index.php/JRI/article/view/17017', 'tld': 'kne-publishing.com', 'clearbit-logo': '/static/no_logo.svg', 'coaccess': [], 'multiple-resolution': [{'url': 'https://www.jri.ir/article/140239', 'tld': 'jri.ir', 'clearbit-logo': '/static/no_logo.svg'}], 'type': 'JOURNAL ARTICLE', 'published_date': '17 November 2024', 'publication': 'Journal of Reproduction & Infertility', 'title': 'Assisted Reproductive Technology Outcomes After Ethanol Sclerotherapy in Poor Responder Patients with Endometriomas: A Before-After Clinical Trial', 'name': None, 'id': None, 'location': None, 'display_doi': 'https://doi.org/10.18502/jri.v25i3.17017', 'grant_info': None, 'grant_info_funders': None, 'grant_info_funder_ids': '', 'grant_info_type': None, 'multiple_lead_investigators': [], 'multiple_co_lead_investigators': [], 'multiple_investigators': [], 'finances': [], 'project_description': None, 'award_amount': None, 'award_start': None, 'funding_scheme': None, 'internal_award_number': None, 'editors': None, 'authors': 'Farah Ghasemi | Ladan Kashani | Ashraf Moini | Maryam Farid Mojtahedi | Roza Shahhosseini | Farzaneh Alemohammad', 'chairs': None, 'supplementary_ids': None} https://doi.org/10.18502/jri.v25i3.17017 JSON XML

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endometriomadysmenorrheadyspareunia

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