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Updated: Aug 25, 2025
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Impact of Laparoscopic Sclerotherapy for Ovarian Endometriomas on Ovarian Reserve
Adrien Crestani1, Benjamin Merlot2, Thomas Dennis2
1From the Franco-European Multidisciplinary Endometriosis Institute (IFEMEndo), Clinique Tivoli-Ducos, Bordeaux (Drs. Crestani, Merlot, Dennis, Lacheray, and Roman); and Sorbonne Université, Paris (Dr. Crestani), France.
Study:
Objective: To evaluate the impact of laparoscopic sclerotherapy on the management of endometrioma during surgery 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:
Antimüllerian hormone (AMH) levels before and at least 6 months after surgery, recurrences, 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.
