Levonorgestrel Relesing Intrauterine System Versus Desogestreland Ethinyl Estradiol In Ovulatory Dysfunction Abnormal Uterine Bleeding:A Meta Analysis

Objective:This study aimed to compare the Levonorgestrel releasing intrauterine system(Mirena)withdesogestrel and ethinyl estradiol(Marvelon)in ovulatory dysfunction abnormal uterine bleeding(AUB-O)therapy.Methods:The study searched PubMed,EMBASE,the Cochrane Library,the China Biology Medicine disc,and the China National Knowledge Infrastructure(from inception to December 2016);Randomized controlled trials and controlled clinical trials comparing theMirenawith Marvelonin patients with AUB-O were included.RevMan 5.3 software was used for data processing and analysis.Results: Seven articles that included 525 women(Mirena,n=263;Marvelon,n=262)met inclusion criteria.This Meta-analysis found that(1)the Mirenawas significantly higher in reducing menstrual blood loss compared with the Marvelon.[MD=-26.65,95%CI=(-29.95,-23.35),P<0.00001];(2)Mirenagroup had lower PBAC score than Marvelon group [MD=-29.11,95%CI=(-32.90,-25.32),P<0.00001];(3)Haemoglobin is higher after theadministration of Mirena than Marvelon [MD=14.57,95%CI=(13.14,16.01),P<0.00001,];(4)liver function in both groups did not differ(P>0.05);(5)cholesterol and triglyceride were decreased in Mirena group compared with Marvelon group[cholesterol MD=-0.64,95%CI=(-0.70,-0.59),P<0.00001,triglyceride MD=-0.22,95%CI=(-0.25,-0.19),P<0.00001];(6)the rate of adverse reaction in gastrointestinal tract was lower inMirena group [RR=0.45,95%CI=(0.22,0.92),P=0.03].Conclusions: Mirenawere more effective in AUB-O therapy than Marvelon.Mirena provides a better choice to the management of heavy menstrual bleeding associated with AUB-O.Futher large-scale and multicenter randomized rials are required to precisely evaluate the outcomes.