Sclerotherapy in the management of ovarian endometrioma: systematic review and meta-analysis

Objective: To evaluate the efficacy of sclerotherapy for ovarian endometrioma on the risk of recurrence, clinical symptoms, and reproductive function. Design: Systematic review and meta-analysis. Setting: Not applicable. Patient(s): Patients who underwent sclerotherapy of ovarian endometrioma. Intervention(s): An electronic-based search with the use of Pubmed, Embase, Ovid Medline, Google Scholar, Clinicaltrials. gov, and the Cochrane Central Register of Controlled Trials. Main Outcome Measure(s): Recurrence rate, symptoms relief, fertility outcome, and adverse events. Result(s): Eighteen studies were included in our review. The overall recurrence rates of endometrioma after sclerotherapy ranged from 0 to 62.5%. The risk of recurrence was significantly higher in women who were treated by means of ethanol washing than by means of ethanol retention. The number of oocytes retrieved was higher after endometrioma sclerotherapy compared with laparoscopic cystectomy, but clinical pregnancy rates were similar. There was no difference in the number of oocytes retrieved and the clinical pregnancy rates between the sclerotherapy-treated group with and the untreated group. Conclusion(s): Sclerotherapy for ovarian endometrioma may be considered in symptomatic women who plan to conceive. (C)2017 by American Society for Reproductive Medicine.