Treatment of clomiphene citrate-related ovarian cysts in a prospective randomized study. A single center experience.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Altinkaya
Sunduz Ozlem
SO
Department of Infertility, Dr Zekai Tahir Burak Women's Health Care Education and Research Hospital, Ankara, Turkey. altinkayaozlem@yahoo.com
Talas
Betul Bayir
BB
Gungor
Tayfun
T
Gulerman
Cavidan
C
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002996:Clomiphene / Q000009:adverse effects*; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004967:Estrogens / Q000008:administration & dosage; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D016912:Levonorgestrel / Q000008:administration & dosage*; D010048:Ovarian Cysts / Q000139:chemically induced* / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
D003280:Contraceptives, Oral, Synthetic; D004967:Estrogens; D005300:Fertility Agents, Female; D002996:Clomiphene; D004997:Ethinyl Estradiol; D016912:Levonorgestrel