Conservative management of ovarian endometrioma with sclerotherapy using ethanol prior to in vitro fertilization

Rojas-Ruiz J.C.; Salazar-Cuba X.; Guzmán-Pérez S.B. · Revista Peruana de Ginecologia y Obstetricia (2023) · DOI: 10.31403/rpgo.v69i2483

Resumen

Ovarian endometrioma is a cyst with ectopic endometrial tissue associated with decreased ovarian reserve. Its management in infertility is controversial. We present the case of a 32-year-old woman with decreased ovarian reserve and endometrioma larger than 100 mm. She underwent ultrasound-guided transvaginal aspiration and subsequent sclerotherapy with ethanol, achieving a 65% reduction in size after three months. Subsequently, in vitro fertilization (IVF) was performed, and pregnancy was achieved. The excision of the endometrioma is controversial because it reduces the ovarian reserve. Sclerotherapy has been shown to preserve ovarian reserve, is associated with a low recurrence rate and facilitates ovarian accessibility. Ethanol sclerotherapy of endometrioma is a safe and efective outpatient technique that allows pregnancy in women with infertility.

Instituciones: Universidad Nacional de Trujillo; Universidad César Vallejo