Desogestrel 75microgram tablets

PurposeThis systematic review and network meta-analysis (NMA) compares four progestins-gestodene (GSD), desogestrel (DSG), drospirenone (DRSP), and levonorgestrel (LNG)-in combined oral contraceptives (COCs) regarding safety, and efficacy for personalized contraceptive selection.MethodsThis systematic review, which searched PubMed, Cochrane, Embase and Medline through Jan 28, 2025, to identify published and unpublished randomised controlled trials (RCTs). We assessed the certainty of evidence using the confidence in network meta-analysis (CINeMA) framework. We estimated summary standardised mean differences (SMDs) and odds ratios (ORs) using NMA with random effects by STATA and GeMTC software. The outcomes included breakthrough bleeding (BTB), irregular bleeding (IB), withdrawal bleeding days, pregnancy rates, and adverse events.ResultsEighteen RCTs were included. GSD demonstrated the lowest incidence of BTB and IB (OR 0.41 (0.26, 0.66); OR 0.67 (0.52, 0.86)). For withdrawal bleeding days, DRSP ranked highest (SUCRA 40.1; I2 = 27%, p = 0.222), followed by GSD, LNG and DSG. Contraceptive efficacy was highest for DSG (OR 0.74, (0.31-1.73); SUCRA = 51.3%) followed by DRSP and GSD, with LNG being the least effective. Regarding safety, DRSP had the lowest adverse event rate (OR 0.84, 0.60-1.19); SUCRA = 66.9%), followed by LNG and DSG, while GSD was associated with the highest.ConclusionThe four progestogens demonstrate comparable contraceptive efficacy while exhibiting distinct therapeutic advantages in their respective clinical applications. DSG for routine use, GSD for bleeding control, DRSP for minimizing androgenic effects, and LNG for emergency contraception.Trial registrationPROSPERO ID: CRD42024582991.

Abstract licence: CC BY-NC-ND

The objective was to compare the preventive effect of combined oral contraceptive pills (COCs) to the expectant management approach on the incident of corpus luteal cysts following oocyte retrieval in in vitro fertilization (IVF). A total of 130 IVF patients at the Infertility Unit of Siriraj Hospital were randomized into two groups following ovarian stimulation and oocyte retrieval. Participants in the study group received COCs containing 0.15 mg desogestrel and 0.02 mg ethinyl oestradiol per pill for 21 days (n = 65), while the comparison group underwent expectant management (n = 65). Transvaginal ultrasonography was performed to detect corpus luteal cysts (mean cyst diameter ≥ 10 mm) at 2 and 4 weeks after oocyte retrieval. Baseline characteristics were similar between groups. At 2 weeks, the incidence of persistent corpus luteal cysts was 58.4% in the COC group and 69.2% in the expectant management group (p = 0.2). A comparable, non-significant difference was also observed at 4 weeks (26.2% vs. 36.9%, p = 0.19). However, the mean cyst diameter at 4 weeks was significantly smaller in the COC group (5.74 mm vs. 9.39 mm, p < 0.01). The use of COCs does not effectively prevent the formation of corpus luteal cysts at 2 and 4 weeks after oocyte retrieval in the IVF process.

Abstract licence: CC BY