Objective To find the effectiveness of ormeloxifene vs medroxyprogesterone acetate (MPA) to reduce blood loss in dysfunctional uterine bleeding (DUB). Materials and methods: Design—A double blind randomized controlled trial. Data source—The women attending gynecology OPD in teaching hospital attached to Jawaharlal Nehru Medical College, Belgaum, India for menorrhagia, meeting the selection criteria were enrolled into the study. Randomization—Computer-generated randomization, with block size of two, was done into two groups. Intervention—One group (group A) received capsule ormeloxifene 60 mg to be taken two days a week at an interval of 3 days, and a placebo form of medroxyprogesterone acetate for 21 days starting from day 2 to 5 of the menstrual cycle for three consecutive cycles. Other group (group B) received medroxyprogesterone acetate (MPA) 10 mg for 21 days starting from day 2 to 5 of the menstrual cycle, and a placebo form of ormeloxifene for 2 days a week with an interval of 3 days for three consecutive cycles. The drug and its placebo were in similar capsular form. All the participants were ensured to use the similar type of sanitary napkins, and transvaginal ultrasonography was done to note the endometrial thickness (ET) before and after the drug therapy. Blinding—The department of clinical pharmacy prepared the drug packets and kept the randomization code till the data was analyzed, thus ensuring the double blinding. Outcome Participants were interviewed during subsequent cycle. Pictorial blood assessment chart (PBAC) score was used to calculate blood loss during menses at the first and subsequent three months. Data analysis The mean PBAC scores and endometrial thickness were compared in two groups. Results The mean pretreatment PBAC scores in group A and group B were 262.26 and 238.71 ml respectively. The mean PBAC scores at the end of the study period were 73 and 108 in group A and B respectively, reporting an overall reduction in mean blood loss by 85.7 and 54.76% (p = 0.0205) in group A and B respectively. Thus, there was a significant reduction in blood loss in the group receiving ormeloxifene. The reduction in the mean endometrial thickness was more in ormeloxifene group. However, this was not statistically significant (p = 0.0942). Conclusion Ormeloxifene is more effective as compared to MPA in reducing the blood loss in the treatment of DUB.

Aims and objectives To compare the efficacy of urinary human chorionic gonadotropin (uhCG) vs recombinant human chorionic gonadotropin (rhCG) for triggering ovulation in gonadotropinreleasing hormone (GnRH) antagonist in vitro fertilization (IVF) cycle. Materials and methods Two hundred patients who underwent GnRH antagonist IVF/ICSI cycles were analyzed, 100 of them received recombinant hCG 250 μg (injection overtrelle) and another group of 100 received urinary hCG (injection ovutrig) either 5000 IU or 10,000 IU for final oocyte maturation and ovulation trigger. The primary outcome measured was total oocytes retrieved and the secondary outcome measured 09 was the maturity rate fertilization rate, cleavage rate and clinical pregnancy rates were also compared. Results Age, day 2 follicle stimulating hormone (FSH) and total dose of rFSH were comparable between the groups. There were no significant differences between the groups in terms of the mean number of oocytes retrieved per follicle (uhCG; 12.5, rhCG; 12.09, p-value-0.6698). Similarly, there was statistically no difference in any of the other parameters studied between the two groups. That is number of mature oocytes, number of fertilized oocytes and number of cleaved oocytes, as the p-value was not significant. The clinical pregnancy rate was somewhat higher in the uhCG group but was not statistically significant. Both treatments were well tolerated and there was no significant side effects for either drug. Conclusion There is no difference in clinical outcomes between urinary and recombinant hCG for induction of final oocyte maturation. Additional factors, including the cost, drug availability and ease of administration, should be considered, when choosing gonadotropin type. How to cite this article Sidhmalswamy GA, Srinivas MS, Dipika K, Anu K, Rao KA, Mekhala D. Comparing the Efficacy of Urinary hCG vs Recombinant hCG for Final Maturation of Oocyte in GnRH Antagonist IVF/ICSI Cycle. Int J Infertility Fetal Med 2012;3(3):92-96.