GnRH Antagonist Protokolü ile Kontrollü Overyen Hiperstimulasyon Öncesi Endometrioma Aspirasyonu ve Etanol Skleroterapisinin İntrasitoplazmik Sperm Enjeksiyonu Sonuçlarına Etkisi

Abstract

Objective: the aim of the study was to determine whether endometrioma aspiration and alcohol sclerotherapy performed prior to controlled ovarian stimulation has any beneficial effects on ICSI outcomes in patients with endometriomas.
 Methods: The cycle characteristics and pregnancy outcomes of 103 patients with endometriomas who underwent ethanol sclerotherapy on day 2 of the controlled ovarian stimulation with a gonadotropin antagonist protocol were retrospectively compared with the cycle characteristics of 405 patients with endometriomas who did not receive scleroterapy before stimulation.
 Results: No statistically significant difference was observed in the number of retrieved oocytes, metaphase II oocytes, fertilization and good quality embryo rates between the two groups. The clinical pregnancy rate, implantation rate and live birth rates were similar among the two groups. No major complications including intraperitoneal haemorrhage, peritonitis, ovarian abscess or intestinal perforation were recorded.
 Conclusion: The results of the present study indicate that ethanol sclerotherapy does not improve ICSI outcomes when performed right before ovarian stimulation and without concomittant GnRH analogue administration. Since it is a simple outpatient procedure without significant complications, ethanol sclerotherapy may be performed prior to IVF as an alternative to surgery to improve the accessibility of follicles and monitoring of follicle growth in patients with large endometriomas and for those patients with intractable pain symptoms, without decreasing the ovarian reserve.