14 Responses to “Endometriomas: Sclerotherapy Provides a Non-Surgical Solution”

1. linda says:

   October 27, 2009 at 12:39 pm

   Dr. Sher,

   Is this procedure (sclerotherapy) offered at the NY office? I am scheduled for an ovarian cyst aspiration there on Thursday – I also have an endometrioma on my other ovary (which is being non productive due to the endometrioma) and wonder if they can tackle this at the same time.

   How soon after sclerotherapy can IVF be done? I am 44 so I'm interested in the quickest/best solution.

   Thank you.

   Reply
2. Geoffrey Sher, MD says:

   October 27, 2009 at 1:26 pm

   Yes! It is available at all SIRM centers and you need a 6 week break before IVF.

   Good luck!

   Geoff Sher

   Reply
3. linda says:

   October 27, 2009 at 1:46 pm

   Thanks Dr. Sher. I think Dr. T's office is trying to schedule the procedure for me as we write. I hope this works as I've been experienced quite a bit of ovarian pain from the endometrioma. I am relieved that there is an answer to this outside of having a lap to remove it.

   Reply
4. Stefanie says:

   May 10, 2011 at 6:33 am

   Dr. Sher, My name is Stefanie. I am suffering from endometrisis and ovarian cysts as a result. My doctor has performed fluid aspiration twice and the cyst is back. Can you please help me? It is hard for me to conduct my daily life in constant pain.

   Reply
5. carol says:

   December 6, 2012 at 4:58 am

   Dr Sher, I have endo and currently have 5 frozen embryos. I plan on doing the et in January 2013. I have two endo cysts on each side 6 cm and 9 cm. My Dr said the cysts should not decease my chance with the et. Do I need to address the cysts before the et? I need your advice pls help.

   Carol

   Reply
   • Geoffrey Sher says:

     December 6, 2012 at 9:43 am

     Respectfully, I disagree. Sizable endometriomas will likely interfere with egg quality in the affected ovary(ies). They would need removal or sclerotherapy. See my blog on this site on endo. Also, be aware that about 1/3 of women with endiometriosis have immunologic implantation issues relating to NK cell activation. This would need attention in my opinion, if IVF is to have a reasonable chance

     Geoff Sher

     Reply
6. Mary says:

   February 8, 2013 at 3:44 pm

   How much pain is normal to experience after sclerotherapy of an endometrioma? My doctor did this procedure yesterday using 95% ethanol because he couldn’t find the tetracycline anymore to treat a small endometrioma on my left ovary. He said the ethanol leaked out of the cyst. I experienced a LOT of pain after the procedure and am still in pain (Vicodin helps, but I still have aching and stabbing/pulling pains even after taking Vicodin). Is it normal to need narcotic pain medication after sclerotherapy?

   Reply
   • Geoffrey Sher says:

     February 8, 2013 at 7:18 pm

     I do not use ethanol for this. We use 5% tetracycline hydrochloride and yes…if it leaks out it can cause severe pain. To avoid this from happening, we infuse sterile normal saline (about 1.5 liters into the pelvic cavity in advance so that if leakage occurs it dilutes out in the saline solution.. Then after the procedure we drain out the pelvic saline. In this way pain is minimized.

     Geoff Sher

     Reply
7. Mary says:

   February 9, 2013 at 6:51 am

   I just read that this says there is the possibility of adhesion formation with this procedure. I just got pregnant 100% naturally (from my left ovary no less) and miscarried two weeks ago. I was doing IVF only to freeze eggs for the future but intended to try to conceive naturally again after that. Now I’m worried that this procedure just took a perfectly functioning system and broke it! There is no way this didn’t cause damage somehow with the amount of pain I’m having. He didn’t tell me this was not a good option for someone with open tubes who could get pregnant naturally.

   Reply
   • Geoffrey Sher says:

     February 9, 2013 at 11:25 pm

     Egg Retrieval should in no way expose you to pelvic adhesions. I have been doing IVF for >30 years and have not seen this happen.

     Geoff Sher

     Reply
8. Mary says:

   February 10, 2013 at 8:41 am

   Not egg retrieval – sclerotherapy of an endometrioma is what is written at the top of this page as saying can cause adhesions. My doctor did the sclerotherapy on me with 95% ethanol 3 days ago and it leaked. I have had pain so bad it requires narcotic pain medication and went to the ER yesterday where I only got relief with dilaudid. They did an ultrasound and discharged me and said it looks normal – but this amount of pain is NEVER normal to me. The ER doctor spoke with the doctor who did my sclerotherapy and he told her it was just alcohol and so it is only irritating and can’t have caused any damage inside if it leaked. I had a perfectly functional set of tubes and ovaries prior to this sclerotherapy because I had a clear HSG and just got pregnant naturally (but miscarried). Your page says sclerotherapy should only be done in patients who cannot get pregnant any other way than with IVF. I’m worried that now I will have scarring because he did sclerotherapy and the sclerosant leaked – I’m in horrible pain for days and nobody seems the least bit concerned – especially the doctor who did the sclerotherapy.

   Reply
   • Geoffrey Sher says:

     February 10, 2013 at 7:53 pm

     Indeed, sclerotherapy can cause adhesions. That is why I do not recommend it in cases where a commitment to IVF has not been made. As I said, we do not use alcohol for sclerotherapy of endometriomas. We use 5% tetracycline hydrochloride. And yes, leakage causes pain and that is why we infuse 1500cc of saline solution before the procedure and extract it afterwards (as I described in my previous response to you).

     Good luck!

     Geoff Sher

     Reply
9. Christine says:

   May 21, 2013 at 8:18 pm

   Hi Dr. Sher,
   I have had 4 laps for endometriomas, so as you can imagine, I am intrigued by the notion that I may be able to resolve this current endometrioma with an even less invasive option! I have several questions. In my last lap, I had a partial hysterectomy (uterus removed), so I would not be a fertility patient – would your office still be willing to treat the endometioma? Also, with the uterus being gone, would that complicate the sclerotherapy procedure? My gyn suggested I ask if bowl perf is a risk? Lastly, is the risk of adhesion worse than if I were to have surgery to remove the cyst and ovary? Ultimately, I know the removal of the ovary is the only way to keep the cysts from forming, but I am 40, very thin boned (5’3″ and 90lbs), and trying to preserve the ovaries for as long as possible as heart disease and osteo both run in the family, and early menopause wouldn’t be good for either of those conditions.Thank you for your time!

   Reply
   • Geoffrey Sher says:

     May 21, 2013 at 10:21 pm

     Of course we would be able to do sclerotherapy even in the absence of a uterus. I did such a case today. The risk of complications in my opinion is far less than surgery and the success rate at least as good…perhaps even higher. Please go to http://www.IVFauthority.com . When you get there, go to the home page and look for the “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.

     1. “Endometriosis”

     2. “Sclerotherapy of Ovarian Endometriomas””

     Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail

     Geoff Sher

     Reply