This investigation demonstrates the effectiveness of dienogest treatment in reducing chocolate cyst sizes in women, indicating its potential for fertility preservation.
Objective: Surgical treatment to remove chocolate cysts requires careful consideration when women desire fertility preservation. Thus, we investigated the effectiveness of conservative dienogest (DNG) treatment in patients with chocolate cysts. Materials and Methods: Forty Japanese patients with chocolate cysts who were treated with DNG were analyzed. We analyzed the ovarian cyst diameter and the reduction rate after 6 months or more of DNG treatment and compared the group that exhibited a complete (CR) or partial response (PR) after DNG treatment with the group that did not experience ovarian cyst reduction. Results: The reduction rate was the highest among no greater than 40-mm-wide ovaries, and the effect of DNG decreased when ovaries were 60-70 mm wide. The Spearman correlation coefficient for the association between the ovarian cyst diameter and the reduction rate was r = -0.478, P < 0.01, which indicates a moderate negative correlation. A significant difference was observed in the diameter of ovarian cysts between the group that achieved PR after DNG treatment and the group that did not experience a reduction in ovarian cyst diameter (48.1 ± 13.4 vs 79.6 ± 33.8 mm, P < 0.001). The area under the receiver operating characteristic (ROC) curve was 0.816. For the optimal ovarian cyst diameter, the cutoff value was set at 55.5 mm. Conclusion: Long-term preservation therapy consisting of DNG should be considered in patients with chocolate cysts <60 mm to achieve PR.
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弘明 et al. (2020) studied this question.
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