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Updated: Aug 6, 2026
Fertility Sparing Procedure using Carbon Dioxide Fiber Laser Vaporization of Ovarian Endometrioma
Published on: July 6, 2022
Sclerotherapy of Ovarian Endometriomas During Oocyte Preservation: A Prospective Feasibility Cohort Study
César Lizán Tudela1, Laura Gregori Navarro2, Alba Verdú García3
1Department of Obstetrics and Gynecology, Hospital Clínico Universitario de Valencia, Valencia, Spain; INCLIVA Biomedical Research Institute, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynaecology, Faculty of Medicine and Odontology, Universitat de València, Valencia, Spain.
Objective:
To evaluate the feasibility, safety, and preliminary efficacy of concurrent transvaginal ovarian puncture for oocyte retrieval and ethanol sclerotherapy of ovarian endometriomas (eSCLT) during controlled ovarian stimulation.
Design:
Prospective single-center pilot cohort study with a before-after design and no randomization.
Setting:
Assisted Reproductive Technology Unit of a public tertiary hospital in Spain.
Patients:
Twenty-three women aged 18 to 40 years seeking fertility preservation, presenting with unilateral endometrioma ≥3 cm or bilateral endometrioma with at least 1 cyst >3 cm.
Interventions:
Combined transvaginal oocyte pick-up followed by ultrasound-guided eSCLT.
Measurements And Main Results:
Endometrioma volume reduction and symptomatic improvement assessed by Visual Analog Scale (VAS) pain scores and Endometriosis Health Profile-30 (EHP-30). Secondary outcomes included variations in ovarian reserve parameters (antral follicle count [AFC] and anti-Müllerian hormone [AMH] assessed before the procedure and at 3-month follow-up). Endometrioma volume showed a statistically significant reduction from a mean (SD) of 53.04 (39.34) cm3 pre-intervention to 8.32 (9.20) cm3 at 3 months (p = .002). VAS scores decreased from 7.24 (1.82) to 5.53 (2.63) (p = .037), and EHP-30 total scores improved from 78.35 (17.92) to 48.53 (18.95) (p < .001). Ovarian reserve markers remained stable (AMH: 2.50 [2.03] vs 2.37 [1.94] ng/mL, p = .82; AFC increased from 9.50 [6.16] to 14.10 [8.33] follicles, p = .03). One Clavien-Dindo Grade III complication (infection requiring surgical intervention) occurred.
Conclusion:
This pilot study suggests that combined oocyte vitrification and eSCLT is a feasible minimally invasive approach associated with substantial cyst volume reduction and improvements in pain and quality of life. These findings should be interpreted as preliminary and hypothesis-generating, warranting validation in controlled comparative studies.
