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Background <p>Pelvic congestion syndrome(PCS) is a complex condition, with ongoing controversies regarding its diagnosis, treatment, and long-term effects, especially concerning reproductive health. Endovenous embolization performed for PCS may alter pelvic hemodynamics and ovarian perfusion, which may change ovarian reserve and menstrual cycle characteristics. This study aimed to investigate the efficacy and impact of endovenous embolization on ovarian reserve and menstrual cycle parameters in patients with PCS.</p> Methods <p>This retrospective, single-centre study analysed data from 81 patients diagnosed with PCS who underwent endovenous embolization. Symptom-specific Visual Analogue Scale(VAS) scores, serum anti-Müllerian hormone(AMH), follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), prolactin levels, and menstrual cycle characteristics were evaluated before and 6 and 12 months after the procedure. The primary outcome of this study was improvement in symptoms. Secondary outcomes included changes in serum hormone levels and menstrual cycle characteristics. We categorized our study population into four age groups(&lt; 30, 30–34, 35–39, and 40–44 years) to minimize the impact of age as a confounding variable. These groups were designated as G1, G2, G3, and G4, respectively.</p> Results <p>A statistically significant decrease was observed in VAS scores related to chronic pelvic pain(CPP), dyspareunia, and dysmenorrhea. A statistically significant decrease in serum AMH levels was observed 6 and 12 months after endovenous embolization. We observed a decline in AMH levels in G1, G2, G3, and G4(9.75±6.67%, 9.48±4.38%, 12.49±12.11%, and 13.79±11.46%, respectively). No significant changes were found in serum FSH, LH, E2, and prolactin levels. Additionally, a statistically significant decrease in menstrual cycle duration was detected after the procedure.</p> Conclusions <p>Our study demonstrated that endovenous embolization appears to be an effective treatment modality for symptom relief. The effect of endovenous embolization on ovarian reserve was generally consistent with physiological changes associated with age, but changes in patients under the age of 30 should not be overlooked. Larger, prospective, multi-centre studies are warranted to validate these findings and explore the long-term effects of endovenous embolization regarding reproductive health.</p> Trial registration <p>Not applicable.</p>

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Efficacy of endovenous embolization for pelvic congestion syndrome and its impact on ovarian reserve

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月9日

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  • Haluk Caglar Karakaya,
  • Busranur Dirican Ozen,
  • Pelin Eskin,
  • Ege Dursun,
  • Murat Ugur,
  • Ecem Yüksel,
  • Melike Yurttas

摘要

Background

Pelvic congestion syndrome(PCS) is a complex condition, with ongoing controversies regarding its diagnosis, treatment, and long-term effects, especially concerning reproductive health. Endovenous embolization performed for PCS may alter pelvic hemodynamics and ovarian perfusion, which may change ovarian reserve and menstrual cycle characteristics. This study aimed to investigate the efficacy and impact of endovenous embolization on ovarian reserve and menstrual cycle parameters in patients with PCS.

Methods

This retrospective, single-centre study analysed data from 81 patients diagnosed with PCS who underwent endovenous embolization. Symptom-specific Visual Analogue Scale(VAS) scores, serum anti-Müllerian hormone(AMH), follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), prolactin levels, and menstrual cycle characteristics were evaluated before and 6 and 12 months after the procedure. The primary outcome of this study was improvement in symptoms. Secondary outcomes included changes in serum hormone levels and menstrual cycle characteristics. We categorized our study population into four age groups(< 30, 30–34, 35–39, and 40–44 years) to minimize the impact of age as a confounding variable. These groups were designated as G1, G2, G3, and G4, respectively.

Results

A statistically significant decrease was observed in VAS scores related to chronic pelvic pain(CPP), dyspareunia, and dysmenorrhea. A statistically significant decrease in serum AMH levels was observed 6 and 12 months after endovenous embolization. We observed a decline in AMH levels in G1, G2, G3, and G4(9.75±6.67%, 9.48±4.38%, 12.49±12.11%, and 13.79±11.46%, respectively). No significant changes were found in serum FSH, LH, E2, and prolactin levels. Additionally, a statistically significant decrease in menstrual cycle duration was detected after the procedure.

Conclusions

Our study demonstrated that endovenous embolization appears to be an effective treatment modality for symptom relief. The effect of endovenous embolization on ovarian reserve was generally consistent with physiological changes associated with age, but changes in patients under the age of 30 should not be overlooked. Larger, prospective, multi-centre studies are warranted to validate these findings and explore the long-term effects of endovenous embolization regarding reproductive health.

Trial registration

Not applicable.