Document Type : Original Article
Authors
1
Resident of Gynecology and Obstetrics, Faculty of Medicine - Mansoura University, Mansoura, Egypt
2
Prof. of Obstetrics and Gynecology Department, Faculty of Medicine Mansoura University, Mansoura, Egypt
3
Associate Prof. of Obstetrics and Gynecology Department, Faculty of Medicine Mansoura University, Mansoura, Egypt.
4
Associate Prof. of Obstetrics and Gynecology Department, Faculty of Medicine Mansoura University, Mansoura, Egypt
Abstract
Ethical statement
Authors declare that there is no interest
No fund.
Accepted by the Ethical Research Committee of the Obstetrics and Gynecology Department and institutional review board (IRB) in the Faulty of Medicine (MS.21.12.1763)
Written informed consent was taken from the participants
Introduction
an urgent need for new medication without impeding the patient’s fertility. cabergoline, Metformin, and Clomiphene citrate have been studied in experimental model in cases of endometriosis. however, there was still no evidence of its use with mild endometriosis. Our study’s goal was to see if use these medications could help women with minimal to mild endometriosis.
Methods
Between November 2021 to November 2022, 150 Infertile women with minimal to mild endometriosis were recruited from outpatient Gynecology clinic for this study a prospective, randomized trial.
The cases will be randomly assigned to receive one of the four treatment modalities by using computer generate random table and sealed envelop
Group A: they got cabergoline (0.25 mg twice weekly) for three months.
Group B: they received metformin 500 mg three times daily for three months.
Group C: they received Clomiphene citrate (50mg twice daily for 5days) from second day of menstrual cycle for three months.
Group D: they got placebo once per day during the three months follow up period Serum prolactin (PRL), basal follicular stimulating hormone (FSH), basal luteinizing hormone (LH), basal serum estradiol (E2) and midluteal serum progesterone (P) were measured before the start of the treatment.
After the three months, a clinical evaluation was conducted, which compromised clinical examination with assessment of dysmenorrhea, dyspareunia and pelvic pain, menorrhagia, and pregnancy. A second hormonal assessment was performed.
Results
For group A; 20 cases, for group B 22 cases, for group C 20 cases, and for group D 17 cases were analyzed. The mean prolactin level, mean FSH level, and mean estradiol level after treatment statistically significant difference between studied group and placebo. The pregnancy in studied groups were 8 out of 20 in Group A, 10 out of 22 in Group B, 8 out 20 in Group C, however, 2 out of 17.
Conclusion
We had encouraging results from the use of cabergoline, metformin, and clomiphene citrate in patient with mild to moderate endometriosis.
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