Sclerotherapy of endometrioma and its impact on ovarian reserve – a narrative review

Abstract

To summarize current knowledge on the use of sclerotherapy in the treatment of endometriomas and its effect on ovarian reserve. Endometriosis affects 10–15% of women of reproductive age. The presence and treatment of endometriomas influence ovarian reserve, and therefore the conception possibilities of patients. The management is further complicated by frequent recurrences. All standard surgical methods lead to a reduction in ovarian reserve. Current clinical research is focused on developing methods that minimize the reduction of ovarian reserve. Ethanol sclerotherapy is a relatively new alternative to the currently used surgical methods, mainly extirpation. It is not yet a standard procedure. This article aims to summarize the current knowledge regarding the use of sclerotherapy in the treatment of endometriomas and its effect on ovarian reserve. The studies included in this review article are based on PubMed and Scopus databases. According to published works, sclerotherapy is a relatively simple method that allows treating endometriomas without surgery and general anaesthesia if performed under ultrasound guidance. It has a similar recurrence rate as laparoscopic extirpation and does not lead to a greater reduction in ovarian reserve compared to the latter. Sclerotherapy can be performed trans-vaginally, trans-abdominally, or laparoscopically. This paper summarizes the current knowledge on the impact of sclerotherapy on ovarian reserve.