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

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 ¼ 30) for 10 days combined with a tablet of raloxifene (60 mg) per vaginam (group A); oral desogestrel at 60 mg/day (n ¼ 30; group B); or oral danazol at 200 mg, three times a day (n ¼ 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. (Fertil Steril 2007;88:698–701. 2007 by American Society for Reproductive Medicine.)