Summary of findings 2.
Pentoxifylline compared to placebo or no treatment/standard care for female subfertility
| Pentoxifylline compared to placebo or no treatment/standard care for female subfertility | ||||||
| Patient or population: subfertile women who had been referred to a fertility clinic and might or might not be undergoing assisted reproductive techniques Setting: fertility clinic Intervention: pentoxifylline Comparison: placebo or no treatment/standard care | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with placebo or no treatment/standard care | Risk with Pentoxifylline | |||||
| Live birth; pentoxifylline vs placebo or no treatment/standard treatment (natural conceptions and undergoing fertility treatments) | 250 per 1,000 | 339 per 1,000 (185 to 538) | OR 1.54 (0.68 to 3.50) | 112 (1 study) | ⊕⊝⊝⊝ VERY LOW 1, 2 | |
| Clinical pregnancy; pentoxifylline vs placebo or no treatment/standard treatment (natural conceptions and undergoing fertility treatments) | 245 per 1,000 | 401 per 1,000 (280 to 535) | OR 2.07 (1.20 to 3.56) | 276 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW 3, 4 | |
| Adverse events ‐ Miscarriage | 43 per 1,000 | 57 per 1,000 (20 to 150) | OR 1.34 (0.46 to 3.90) | 276 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW 2, 3 | |
| Adverse events ‐ Multiple pregnancy | 89 per 1,000 | 71 per 1,000 (19 to 233) |
OR 0.78 (0.20 to 3.09) |
112 (1 study) | ⊕⊝⊝⊝ VERY LOW 1, 2 | |
| Adverse events ‐ Gastrointestinal disturbances | Not reported in any included study | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the mean risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1Downgraded one level due to questionable applicability: study table states that cause of infertility is male in 51 of 112 participants, although text states that the participants were 112 infertile women.
2Downgraded two levels due to very serious imprecision; the event rate is very low (n = 33 for live birth, n = 14 for miscarriage, n=9 for multiple pregnancy), wide confidence intervals.
3Downgraded two levels due to questionable applicability of one study (see footnote 1) and very serious risk of bias: all studies at unclear or high risk of bias in one or more domains.
4Downgraded one level due to serious imprecision; the event rate is low (n = 87).