Induction of Ovulation by Clomiphene Citrate Following Laparoscopic Surgery for Endometriosis Stage I and Stage II with and without Suppression by Dienogest (A Randomized Controlled Trial)

Abstract

T his is a randomized controlled trial that was held in Ainshams university hospital where patients with definite diagnosis of stage I and stage II endometriosis were randomized into two groups. The first group group A (424 patients) received dienogest 2mg tablet daily for three months then OI by clomiphene citrate tablets for three cycles and the second group group B (419 patients) who received directly OI by clomphene citrate tablets for three cycles. The main adverse effect of dienogest was irregular vaginal bleeding experienced by about half of the patients in the first group. Other adverse effects but less prominemt were headache and breast tenderness. All these patients discontinued the dienogest or OI before performing a pregnancy test. In group A 153 (36%) out of 424 had a positive pregnancy test. In group B, 98 patients (23.3%) had a positive pregnancy test. This shows that dienogest suppression of endometriosis prior to induction increases live birth rate.