Changes in anti-müllerian hormone after ultrasound guided aspiration and ethanol sclerotic therapy of ovarian cyst

Huang L, Lulu Huang, Chang MY, Ming-Yang Chang, Ming‐Yang Chang, Shiau CS, Chii-Shin Shiau, T'sang-T'ang Hsieh, T’sang‐T’ang Hsieh, Hsieh TT
Taiwanese journal of obstetrics & gynecology · 2021 · vol. 60(3) , pp. 509–512 · doi:10.1016/j.tjog.2021.03.021 · PMID:33966737 · W3158194426
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Transvaginal ultrasound-guided aspiration and ethanol sclerotherapy of ovarian endometriomas did not significantly impact pre-operative AMH, but ethanol retention at six months correlated with a greater AMH decrease.

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Abstract

OBJECTIVE: To evaluate the effect of transvaginal ultrasound-guided aspiration and ethanol sclerotherapy on anti-müllerian hormone (AMH) in patients with ovarian endometriomas. SETTING: Teaching hospital affiliated with Chang Gung University, Taipei. MATERIAL AND METHODS: We retrospectively reviewed 124 patients, with ovarian endometriomas who underwent transvaginal aspiration and sclerotherapy of endometrioma(s) at a tertiary medical center, Chang Gung Memorial Hospital, Taipei, Taiwan. Preoperative evaluation included AMH, midcycle serum CA-125 level, and ultrasonography to exclude possibility of malignancies. Patients underwent ultrasonographic guided transvaginal aspiration and sclerotherapy with 95% ethanol irrigation of the cystic cavity. Patients were grouped into group 1, n = 44, retention of ethanol, and group 2, n = 80, no retention. Serum AMH level was checked at 6 months after aspiration. Those who were infertile prior to therapy were followed up for subsequent pregnancies (either by assisted reproductive technologies, or by natural conception). RESULTS: The mean pre-operative AMH levels for the group without retention of ethanol and with ethanol retention were 3.80 and 3.06 respectively (p > 0.05). The change in AMH at 6-month follow up for retained group patients was significantly more than for non-retained group patients, with mean decrease of 0.72 (23.6%) and 0.10 (2.7%) respectively (p < 0.05). 54.5% (retained) and 47.2% (non-retained) of patients failed to achieve pregnancy during the observation period. CONCLUSIONS: Transvaginal aspiration of endometriomas followed by sclerotherapy with ethanol can be effective in preserving ovarian reserve, provided that no ethanol is left in situ.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Anti-Mullerian Hormone Endometriosis Ovarian Cysts Sclerotherapy Ultrasonography, Interventional Adult Adult Anti-Mullerian Hormone Anti-Mullerian Hormone Combined Modality Therapy Combined Modality Therapy Endometriosis Endometriosis Endometriosis Ethanol Ethanol Ethanol Female Female Fertility Preservation

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