Rapid endometrial preparation for hysteroscopic surgery with oral desogestrel plus vaginal raloxifene: a prospective, randomized pilot study.

Author(s): Cicinelli E, Pinto V, Tinelli R, Saliani N, De Leo V, Cianci A

Affiliation(s): Department of Obstetrics and Gynecology, University of Bari, Bari, Italy. cicinelli@gynecology1.uniba.it <cicinelli@gynecology1.uniba.it>

Publication date & source: 2007-09, Fertil Steril., 88(3):698-701. Epub 2007 Aug 6.

Publication type: Randomized Controlled Trial

OBJECTIVE: To evaluate the effects after 10 days of an original treatment combining oral progestins with vaginal raloxifene to maximize the antiproliferative effect on the endometrium. DESIGN: Prospective, randomized, clinical pilot study. SETTING: Academic research environment. PATIENT(S): Ninety women with endometrial polyps. INTERVENTION(S): On day 1 of the subsequent menstrual cycle, patients were randomized to receive oral desogestrel (n = 30) for 10 days combined with a tablet of raloxifene (60 mg) per vaginam (group A); oral desogestrel at 60 mg/day (n = 30; group B); or oral danazol at 200 mg, three times a day (n = 30; group C). MAIN OUTCOME MEASURE(S): Ultrasound measurement of endometrial thickness on day 11 of both the pretreatment and treatment cycles, surgeon satisfaction (0 to 10, visual analogue scale), and side effects. RESULT(S): At the second evaluation, the mean percentage reduction in endometrial thickness in group A was statistically significantly greater than in the other groups. Surgeon satisfaction in terms of endometrial thinning was also greater with group A. CONCLUSION(S): Oral desogestrel plus vaginal raloxifene provides a fast, low-cost, and satisfactory preparation of the endometrium for operative hysteroscopy.