title: Aspiration and ethanol sclerotherapy to treat recurrent ovarian endometriomas prior to in vitro fertilization - a pilot study.
abstract: OBJECTIVE
  To describe the evolution of controlled ovarian hyperstimulation in women with recurrent ovarian endometriomas treated with sclerotherapy.
  
  
  METHODS
  Twenty-one patients with a laparoscopic diagnosis of stage III or IV endometriosis who had an endometrioma larger than 3 cm before ovarian hyperstimulation for in vitro fertilization were included in the study. After using a GnRH agonist analog for at least 20 days, the cysts were punctured using ultrasound guidance and subsequent ethanol sclerotherapy was performed. Then, the patients were stimulated with 100 or 200 U/day of recombinant follicle stimulating hormone, varying the dose according to the patient's age or history of a previous unilateral oophorectomy.
  
  
  RESULTS
  The ovarian cysts had an average diameter of 4.7 ± 1.4 cm and did not recur after aspiration during the ovulation induction. Oocyte extraction occurred after 11 days of hyperstimulation, with 3.95 ± 3.30 oocytes obtained per cycle, on average. Embryo transfer occurred in 71.4% (15/21) of patients, and the pregnancy rate after transfer was 20% (3/15).
  
  
  CONCLUSIONS
  Aspiration followed by ethanol sclerotherapy prior to in vitro fertilization can be an option for patients who desire a pregnancy and have recurrent endometriomas.
authors.affiliation: Faculdade de Medicina do ABC - FMABC, Santo André, SP, BR.
authors.forename: Gustavo Mendonça
authors.initials: GM
authors.lastname: André
authors.affiliation: Faculdade de Medicina do ABC - FMABC, Santo André, SP, BR.
authors.forename: Fábia Lima
authors.initials: FL
authors.lastname: Vilarino
authors.affiliation: Faculdade de Medicina do ABC - FMABC, Santo André, SP, BR.
authors.forename: Denise Maria
authors.initials: DM
authors.lastname: Christofolini
authors.affiliation: Faculdade de Medicina do ABC - FMABC, Santo André, SP, BR.
authors.forename: Bianca
authors.initials: B
authors.lastname: Bianco
authors.affiliation: Faculdade de Medicina do ABC - FMABC, Santo André, SP, BR.
authors.forename: Caio Parente
authors.initials: CP
authors.lastname: Barbosa