Non-surgical Interventions for Infertility in Endometriosis

Infertile women with endometriosis will be recruited from those attending Dept of Reproductive Endocrinology and Infertility after clinical diagnosis on the basis of sonographic findings of chocolate cyst with or without dysmenorrhea. After evaluating for eligibility criteria and taking informed consent she will be randomized to either cabergoline group or to dydrogesterone group. Women assigned to cabergoline group will receive 0.5 mg cabergoline twice weekly (fridays and tuesdays), after meal at night for 6 months. The dydrogesterone group will receive 10 mg of dydrogesterone twice daily from day 5 to day 25 of menstrual cycle for six months. She will be followed up every month to check for compliance or any side effects. The couple will have intercourse timed with LH kit or intercourse on alternate days from day 10 to day 15 of the cycle if the LH kit is not available. She will visit 3 months and 6 months after the beginning of treatment. At each follow up visit, she will be assessed for pregnancy, visual analog scale for pain and transvaginal sonogram to measure the chocolate cyst. Estimation of serum CA125 and any side effects will be noted.

Inclusion criteria

• Women of reproductive age 18-35 yrs
• Women who are infertile or wish pregnancy
• Sonographic diagnosis of chocolate cyst with or without dysmenorrhea
• Women staying with her husband

Exclusion criteria

• Recurrent endometrioma after previous surgery
• BMI at or more than 30 kg/m2
• Significant abnormalities in renal and liver function.
• Known male factor
• Use of investigational drugs or hormones, concomitant or in last 30 days.