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

Abstract

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 effective outpatient technique that allows pregnancy in women with infertility.