Endometrioma
Conditions
Keywords
Endometrioma, Endometriosis, Sclerotherapy
Brief summary
A randomised controlled trial assessing ovarian reserve after laparoscopic ethanol sclerotherapy of ovarian endometrioma compared to standard treatment of surgical excision of endometrioma. Secondary outcomes will include endometrioma recurrence, symptomatology and inflammatory environment.
Detailed description
Participants with endometrioma(ta), identified on imaging, who are opting for surgical management of endometriosis will be randomly allocated to laparoscopic ethanol sclerotherapy of endometrioma or laparoscopic surgical excision of endometrioma(ta). Any concurrent endometriosis identified at surgery will be excised as per routine care. Ovarian reserve will be assessed by serum anti-Mullarian hormone (AMH) and antral follicle count (AFC), recurrence will me assessed by transvaginal ultrasound, symptomatology will be assessed by EHP-30 questionnaires and changes in inflammation assessed in serum and endometrial biopsy. Each participant will be followed up for a total of 24 months from surgery.
Interventions
PROCEDURESclerotherapy
Laparoscopic ethanol sclerotherapy of endometrioma
PROCEDURERoutine Care
Routine surgical management of endometrioma
Sponsors
Chelsea and Westminster NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Ultra-sonographer
Intervention model description
Randomised control trial
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Female (XX genotype, assigned female at birth) * Age 18-40 * Finding of suspected uni- or bi-lateral ovarian endometrioma(ta) of ≥ 2cm on TVUSS and/or pelvic MRI scan (TVUSS, a uni- or multi-locular ovarian cystic lesion with low level echoes and diffuse homogeneous ground glass appearance; MRI any of, ovarian lesion hyperintense T1 without loss of signal on T1 fat-suppressed images, hypointense T2 exhibiting shading sign and/or T2 dark spot sign, variable restricted diffusion on DWI) * Appropriate to be listed for laparoscopic excision of endometrioma (Endometrioma ≥2cm, pain symptoms attributable to endometriosis where medical management is unsuccessful or unacceptable to the patient, to facilitate ART)
Exclusion criteria
* Postmenopausal status * Suspicion of malignancy * Unable to undergo TVUSS * Declines to take part in the study * Unable to understand verbal or written information in English * Lack of capacity to consent at the point of recruitment * Known safeguarding issues
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ovarian Reserve | 24 months | To determine the statistical difference in ovarian reserve pre- and post- treatment (as measured by serum AMH at 3, 6, 12 and 24 months and antral follicle count at 6, 12 and 24 months) in participants randomised to receive laparoscopic ethanol sclerotherapy or laparoscopic excision of endometrioma |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Endometrioma recurrence | 24 monhts | To determine if laparoscopic ethanol sclerotherapy for ovarian endometrioma alters recurrence of ovarian endometrioma (as measured by TVUSS at 6, 12 and 24 months) as compared to laparoscopic excision of endometrioma |
| Symptomatology | 24 monhts | To determine if laparoscopic ethanol sclerotherapy for ovarian endometrioma affects symptomatology (as recorded by EHP-30) as compared to laparoscopic excision of endometrioma at 3, 6, 12 and 24 months |
| Inflammation | 24 monhts | To determine if laparoscopic ethanol sclerotherapy for ovarian endometrioma alters the inflammatory environment (as measured in blood at 3, 6, 12 and 24 months, and endometrial biopsy at 6 months) as compared to laparoscopic excision of endometrioma |
Countries
United Kingdom
Contacts
Primary ContactSarah Bennet, BSc MBBS MRCOG
Backup ContactThomas Bainton, BM BCh MRCOG MA(Oxon)
Outcome results
None listed