Conservative Management of Endometrioma

Endometriosis is a common disease during fertility and affects about 10% of women. Endometriosis is defined as the existence of endometrial tissue outside the uterine cavity. Common clinical signs of endometriosis include dysmenorrhea, pelvic pain, and infertility. Heterogeneity is seen in clinical and anatomical manifestations of endometriosis. Among the various phenotypes of endometriosis, ovarian endometrioma has the greatest challenge in managing the treatment of infertility. The main surgical procedure for the treatment of endometrioma is laparoscopic cystectomy, although this procedure reduces ovarian reserve and has potentially negative effects on assisted reproduction technologies results. For this reason, in the treatment of endometrioma, there is a tendency to use less invasive methods. Drug therapy is used extensively in the management of endometrioma. A variety of progesterone compounds, oral contraceptive pills, and gonadotropin-releasing hormone agonists or antagonists are used for this purpose. Some studies reported aromatase inhibitors as an effective treatment for endometrioma. These drugs have been shown to be effective in relieving pain, reducing the size of endometrioma, and reducing recurrence after surgery. However, in these cases, the risk of recurrence of the disease after drug discontinuation is high. On the other hand, many studies conducted on the effect of sclerotherapy on the treatment of endometrioma. Sclerotherapy is performed under the guidance of vaginal ultrasound and ethanol is injected into the endometrioma after cyst aspiration. We evaluated two methods of sclerotherapy including ethanol washing and ethanol retention. The results showed that the recurrence rate after sclerotherapy using the ethanol retention method was lower than the ethanol washing method. Keywords * Endometriosis * Sclerotherapy * Infertility