I-20: Sclerotherapy in Recurrent Endometrioma

Endometriosis as a common hormone-dependent gynecologic disease is seen in 10-15% of women of reproductive age. On the other hand, 20-50% of women with infertility have endometriosis and 30-50% women with endometrioma are infertile. One of severe form of endometriosis is endometrioma. Surgery is considered as essential treatment for endometrioma with the recurrence rate of 10%. Many researches showed that the second surgery which performed on these patients my lead to premature ovarian failure (POF) or decreased ovarian reserve. Another option for treatment of endometrioma is sclerotherapy using several materials such as ethanol 50-800, methotrexate, tetracycline and anastrazole. Most of studies in this field used ethanol in two methods: 1. Aspiration of endometrioma, irrigation, injection of ethanol and repeated aspiration after 10 minutes. 2. Retention of ethanol after irrigation. It seems that retention is more effective. In a clinical trial study, we investigated ethanol for the treatment of recurrent endometrioma before IVF. The result showed that pregnancy rate was insignificantly increased in patients treated with sclerotherapy compared to control group (33.3% vs. 15%, p>0.05). The results pointed to a better trend toward the ethanol. We think that in the future sclerotherapy may be used instead of repeated surgery more than before.