Group I: 46 out of the 71 patients (64.7 %) had significant decrease in endometrioma size. Group II: 15 out of 69 patients (21.7 %) had significant decrease in endometrioma size. Paired t test to compare the means of the two groups was highly significant (p < 0.05) CONCLUSION: Cabergoline (dostinex) yields better results in decreasing the size of endometrioma, compared to LHRH-agonist by exerting antiangiogenic effects through vascular endothelial growth factor receptor-2 (VEGFR-2) inactivation. It has no major side effects, easier to administer, and cheaper than LHRH agonists.

In vitro fertilization (IVF) cycles are associated with a defective luteal phase. Although progesterone supplementation to treat this problem is standard practice, estrogen addition is debatable. Our aim was to compare pregnancy outcomes in 220 patients undergoing antagonist intracytoplasmic sperm injection (ICSI) cycles protocol. The patients were randomly assigned into two equal groups to receive either vaginal progesterone alone (90 mg once daily) starting on the day of oocyte retrieval for up to 12 weeks if pregnancy occurred or estradiol addition (2 mg twice daily) starting on the same day and continuing up to seven weeks (foetal viability scan). Primary outcomes were pregnancy and ongoing pregnancy rates per embryo transfer. Secondary outcomes were implantation and early pregnancy loss rates. Pregnancy rates showed no significant difference between group 1 (39.09%) and 2 (43.63%) (p value = 0.3). Similarly, both groups were comparable regarding ongoing pregnancy rate (32.7% group 1 and 36.3% group 2, p value = 0.1). Implantation rates showed no difference between group 1 (19.25%) and group 2 (23.44%) (p value = 0.2). Early pregnancy loss rates were comparable, with 6.3% and 7.2% in groups 1 and 2, respectively, (p value = 0.4). In conclusion, the addition of 4 mg estrogen daily to progesterone for luteal support in antagonist ICSI cycles is not beneficial for pregnancy outcome.

Aim of the studyThe aim of this case-control study is to evaluate the clinical and biochemical efficiency of Inositol versus Metformin in polycystic ovary syndrome. Patients and methodsThe 128 patients who completed the study were divided into group A, which included 62 patients prescribed myo-inositol + D-chiro-inositol, two tabs per day, and group B, which included 66 patients prescribed Metformin 1500 mg per day for 3 months. Then, both groups were followed up for 3 months after the end of the treatment period. All patients underwent the following: baseline vaginal ultrasound, BMI and weight evaluation, Anti mullerian hormones (AMH) evaluation, serum progesterone, and Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR), and were evaluated according to clinical and biochemical outcomes. ResultsSpontaneous menstruation and spontaneous pregnancy rate were significantly higher in group A than in group B: 46.7 and 11.2% in the Inositol group compared with 13.6 and 3.0% in the Metformin group. In terms of weight loss, the difference between both groups was significant in favor of the Inositol group. A significant difference was also detected in terms of a higher progesterone level in group A, whereas AMH and HOMA-IR showed insignificant differences in both groups. ConclusionMyo-inositol + D-chiro-inositol showed significantly better results in terms of weight reduction, resumption of spontaneous ovulation, and spontaneous pregnancy than Metformin in polycystic ovary syndrome patients. However, the effects of both drugs were comparable in decreasing either AMH or HOMA-IR.

Screening by evaluating prolactin and thyroid hormone levels is recommended for all patients with AUB, even in the absence of galactorrhea.