Impact of Laparoscopic Sclerotherapy for Ovarian Endometriomas on Ovarian Reserve

Study: Objective: To evaluate the impact of laparoscopic sclerotherapy on the management of endometrioma during sur-gery for deep infiltrative endometriosis (DIE).Design: Observational study.Setting: Tivoli-Ducos Clinic, Bordeaux.Patients: Sixty-nine patients underwent laparoscopic sclerotherapy for endometrioma during surgery for DIE.Interventions: Laparoscopic sclerotherapy with 95% ethanol solution and DIE surgery.Measurements and Main Results: Antimu euro llerian hormone (AMH) levels before and at least 6 months after surgery, recur-rences, and pregnancies. Mean AMH (ng/mL) levels were 3.4 (2.3) before surgery and 2 (1.7) after surgery (p <.001). Mean difference was 1.29 ng/mL. Preoperative AMH level was the only variable independently associated with an additive decrease in AMH. Mean (standard deviation) follow-up period was 17.5 months (4.6) (range 9-26 months); 18 of 44 patients (40.1%) with pregnancy intent conceived. Of 51 patients who underwent postoperative pelvic ultrasound, 6 (6 of 51, 11.8%) had a recurrence of endometrioma.Conclusion: Laparoscopic sclerotherapy for endometrioma >40 mm during surgery for DIE sclerotherapy has a low impact on AMH, preserves fertility, and prevents recurrence. Journal of Minimally Invasive Gynecology (2023) 30, 32-38. (c) 2022 AAGL. All rights reserved.