Altinkaya Sunduz Ozlem, Talas Betul Bayir, Gungor Tayfun, Gulerman Cavidan
Department of Infertility, Dr Zekai Tahir Burak Women's Health Care Education and Research Hospital, Ankara, Turkey.
J Obstet Gynaecol Res. 2009 Oct;35(5):940-5. doi: 10.1111/j.1447-0756.2009.01041.x.
The present study aims to compare the effectiveness of placebo, low dose and very low dose oral contraceptives (OC) in the treatment of clomiphene citrate (CC)-related ovarian cysts.
A prospective randomized placebo controlled study was undertaken at the Infertility Department of Dr. Zekai Tahir Burak Women's Health Education and Research Hospital. A total of 3250 primary infertile patients were administered CC for ovulation induction because of ovulatory dysfunction and/or unexplained infertility. One hundred and eighty-six women who were diagnosed with CC-related ovarian cysts greater than 20 mm on the third day of the following menstrual cycle, were eligible for the study. Group 1 (n = 62) was treated with very low dose OC (100 microg levonorgestrel + 20 microg ethinyl estradiol [EE]), group 2 (n = 62) with low dose OC (150 microg desogestrel + 30 microg EE) and group 3 (n = 62) with a placebo. The first control was 4 weeks later. Women with persistent cysts (n = 57) were called in 4 weeks later to continue the same treatment.
Demographic data were similar among the groups. At the first month, the regression rates of ovarian cysts were 64.5, 61.3 and 66.1% in groups 1, 2 and 3, respectively (P = 0.849). Among the 57 women (20, 19 and 18 from groups 1, 2 and 3, respectively) with persistent cysts, the regression rates were 65.0, 63.2 and 55.6%, respectively at the second month (P = 0.821). Persistence of ovarian cysts was significantly higher in women with a longer duration of CC treatment than in women with a shorter duration (P < 0.001).
Any treatment might be appropriate for patients with a CC-related ovarian cyst. However, there is no evidence to administer OC for treating CC-related ovarian cysts. Expectant management may also achieve similar success rates.
本研究旨在比较安慰剂、低剂量和极低剂量口服避孕药（OC）治疗克罗米芬（CC）相关卵巢囊肿的疗效。
在泽凯·塔希尔·布拉克博士妇女健康教育与研究医院不孕不育科进行了一项前瞻性随机安慰剂对照研究。共有3250例原发性不孕患者因排卵功能障碍和/或不明原因不孕而接受CC诱导排卵治疗。186例在随后月经周期第3天被诊断出患有直径大于20mm的CC相关卵巢囊肿的女性符合研究条件。第1组（n = 62）接受极低剂量OC治疗（100μg左炔诺孕酮 + 20μg炔雌醇[EE]），第2组（n = 62）接受低剂量OC治疗（150μg去氧孕烯 + 30μg EE），第3组（n = 62）接受安慰剂治疗。首次对照在4周后进行。囊肿持续存在的女性（n = 57）在4周后被召回继续相同治疗。
各组间人口统计学数据相似。第1个月时，第1、2、3组卵巢囊肿的消退率分别为64.5%、61.3%和66.1%（P = 0.849）。在57例囊肿持续存在的女性中（第1、2、3组分别为20例、19例和18例），第2个月时的消退率分别为65.0%、63.2%和55.6%（P = 0.821）。CC治疗时间较长的女性卵巢囊肿持续存在的情况显著高于治疗时间较短的女性（P < 0.001）。
对于CC相关卵巢囊肿患者，任何治疗可能都是合适的。然而，没有证据支持使用OC治疗CC相关卵巢囊肿。期待性处理也可能取得相似的成功率。
