The goal of this clinical trial is to compare pregnancy rates after different surgical treatments for endometriomas in adult women who have one or more ovarian cysts (endometriomas) larger than 2 cm requiring surgery. The main questions it aims to answer are: How many women become pregnant within 24 months after surgery ? What are the birth rates and different types of pregnancies (natural, with fertility treatments, and those continuing beyond 12 weeks)? How often do the endometriomas come back after surgery? What surgery-related complications occur? How do pain levels change after treatment? Researchers will compare different surgical treatment groups to see if one approach results in better pregnancy outcomes and fewer complications. Participants will: Be randomly assigned to different surgical treatment groups Undergo surgery for their endometriomas and endometriosis Attend follow-up visits at 3 months and 24 months after the procedure Have their pregnancy outcomes, pain levels, and potential complications monitored throughout the study period
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
332
Surgical removal of the endometrioma by gently pulling the cyst wall away from the ovarian tissue (divergent traction technique)
It consists of destroying the cyst wall (vaporization) using plasma energy
Ethanol sclerotherapy destroys the endometriotic tissue lining the inner wall of the cyst through prolonged contact with 96% alcohol
IFEMEndo - Clinique Tivoli
Bordeaux, France
To compare pregnancy rates observed up to 24 months after surgery for endometriosis with endometrioma treatment
A Pregnancy is considered if the CGH is \>1000 UI/L or a intra uterine pregnancy after 5 weeks of amenorrhea
Time frame: From enrollment to 24 months after the surgery
To compare birth rates pregnancies
Time frame: From enrollment to 24 months after the surgery
To compare spontaneous pregnancy rates
Time frame: From enrollment to 24 months after the surgery
To compare pregnancies achieved through assisted reproductive technology (ART)
Time frame: From enrollment to 24 months after the surgery
To compare pregnancies progressing beyond 12 weeks of amenorrhea
Time frame: From enrollment to 24 months after the surgery
To compare the recurrence rate of endometriomas, defined as the appearance of an endometrioma larger than 2 cm on the same ovary.
Time frame: From enrollment to 24 months after the surgery
To compare postoperative complication rates
Time frame: During 3 months after the surgery
To compare pain scores using the Biberoglu and Behrman scale (Biberoglu and Behrman >4)
Pelvic pain will be assessed using the Biberoglu and Behrman scale, which evaluates pain in three domains: dysmenorrhea, dyspareunia, and pelvic pain on palpation. Each domain is scored from 0 (no pain) to 3 (severe pain), with a total score ranging from 0 to 9. Higher scores indicate more severe pain (i.e., a worse outcome). A score greater than 4 is considered clinically significant.
Time frame: From enrollment to 24 months after the surgery
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