Statistical analysis
MRS
Descriptive statistics were used to analyze the demographic and clinical characteristics of all participants in the three treatment groups. The frequency distribution of variables was compared among the groups to ensure proper randomization. The outcome variables were FSH and Estradiol levels and MRS scores which they had been quantitively measured 4 and 5 times during one year, respectively. There was only 8 missing data in three groups, which were excluded from analysis. They did not have normal distributions, so the Friedman test was used to examine changes of MRS scores, FSH and estradiol levels over time and the Kruskal-Wallis test was used to compare the mean difference of outcomes among the groups at each time point of measurement. Moreover, Generalized Estimation Equation (GEE) test was employed to investigate the interaction effect of time variable and treatment groups with the studied repeated measurement outcomes. Significance level of α error equal 5% was considered in the analysis.