Cabergoline Versus Dydrogesterone In Infertile Women With Endometriosis: A Parallel-Design Randomized Clinical Trial

Background: The management of infertile women with advanced endometriosis is difficult and controversial. Medications like cabergoline and dydrogesterone which reduce endometriosis-associated pelvic inflammation but do not prevent ovulation can be an alternative to surgery in these women. Objective: To assess and compare the efficacy of cabergoline and dydrogesterone in infertile women with endometriosis. Methods: A parallel design randomized clinical trial was carried out on 18 infertile women with clinically diagnosed endometriosis. They were randomly allocated either to cabergoline (0.5 mg twice weekly for 6 months, plus timed intercourse) or dydrogesteron (20 mg daily from day 5 to day 25 of menstrual cycle for 6 months, plus timed intercourse). The woman was assessed by telephone interview, face-to-face consultation, and transvaginal sonogram at 3 months and 6 months. Results: Four women receiving cabergoline (36.4%) had a pregnancies from the 3rd month onwards. Fourteen women,7 in each group were available for final analysis. The reduction in visual analog scale score of pain in those given cabergoline was 3 times that in those given dydrogesterone. Adequate reduction in the size of endometrioma was achieved in 28.6% of women given dydrogesterone, but not in those given cabergoline. Conclusion: Cabergoline, compared to dydrogesterone has significant pain reduction over a short period of time in infertile women with endometriosis, and in addition promotes pregnancy.