Post-laparoscopic oral contraceptive combined with Chinese herbal mixture in treatment of infertility and pain associated with minimal or mild endometriosis: a randomized controlled trial

Abstract

BackgroundEndometriosis affects fertility negatively. The study aims to evaluate whether laparoscopic surgery combined with oral contraceptive or herbs were more effective than laparoscopic alone in improving fecundity and pelvic pain in women with minimal/mild endometriosis.MethodsA randomized controlled trial (RCT) was conducted in 156 infertile women with minimal/mild endometriosis. After laparoscopic surgery, patients were randomized to three groups: in Group A (n = 52) oral contraceptive (OC) was administered one pill a day, continuous for 63 days without intervals, in Group B (n = 52) OC was administered as above and then Dan’e mixture was added 30 g/day for the latter 30 days, and in control Group C (n = 52) patients tried to get pregnant after surgery without complementary treatment. The follow-up periods were 12 months in Group C and 14 months in complementary medical treatment Group A and B. The pregnant women were further followed up, and labor and pregnancy outcomes were assessed. Primary outcome was pregnancy rate (PR) and live birth rate (LBR). Secondary outcomes included changes of pelvic pain visual analog scale scores and side effects. Analyses were done as intention-to-treat.ResultsThe PR was 46.80% (73/156), and the LBR was 69.86% (51/73). Of the 73 pregnancies, 60 occurred within 12 months of follow-up and 7 of the remaining 13 patients underwent assisted reproductive technology for >1 year. No significant difference was observed in PR and LBR among the three groups. Patients given medical treatment (OCs or OCs plus herbal medicine) had significantly decreased pain scores compared with the laparoscopy alone group.ConclusionsCombination of laparoscopy with OCs or OCs and herbal medicine does not have more advantages than laparoscopy alone in improving fertility of women with minimal/mild endometriosis.Trial registrationChiCTR-TRC-11001820

Phytochemical Analysis, Quantitative Estimations of Total Phenols and Free Radical Scavenging Activity of Bupleurum subovatum from Jerusalem

“…The plant leaves were used for treatment of various infectious diseases and inflammations, 12-13 while the roots extracts were used to treat hemorrhoids, brain and gastrointestinal disorders. 14,[15][16][17] The leaves were also used for female reproductive problems, 18 improving the liver functions and the whole plant is traditionally used for prevention and treatment of cancers. 19 Recently, published studies proved the presence of several compounds in Bupleurum plant which have relevant physio-biological activities.…”

Comorbidities and Quality of Life in Women Undergoing First Surgery for Endometriosis: Differences Between Chinese and Italian Population

“…Given the low pain scores and the better quality of life in Chinese compared to Italian group in our study, a potential role played by the Traditional Chinese Medicine (TCM) should be considered. TCM is commonly used in China to provide pain relief control, the recurrence of endometriosis following surgery, and to improve QoL [24][25][26][27]. TCM users were also less likely to require surgical treatment for endometriosis than non-users [25] and among those operated was effective in controlling recurrences [26,27].…”

Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care

“…Zhu et al 61 conducted a prospective randomized study comparing laparoscopy alone with laparoscopy followed by treatment with oral contraceptives (OCs) or a combination of OCs and the Dan’e mixture, a Chinese herbal combination that has similar properties to danazol. The OC was administered continuously for 63 days after surgery, while HM was added at a dosage of 30 g/day for the latter 30 days.…”