Summary of findings 7. HMG FET versus clomiphene + HMG FET.
| HMG FET versus clomiphene + HMG FET | ||||||
| Population: subfertile women Settings: assisted reproductive technology clinics Intervention: HMG FET Comparison: clomiphene + HMG FET | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Clomiphene+ HMG FET | HMG FET | |||||
| Live birth rate per woman | 84 per 1000 | 186 per 1000 (89 to 347) | OR 2.49 (1.07 to 5.80) | 209 (1 study) | ⊕⊝⊝⊝ very low1,2 | Only 26 events |
| Miscarriage rate per woman | 37 per 1000 | 49 per 1000 (13 to 164) | OR 1.33 (0.35 to 5.09) | 209 (1 study) | ⊕⊝⊝⊝ very low1,3 | Only 9 events |
| Ongoing pregnancy rate per woman | No data available | Not estimable | ‐ | |||
| Multiple pregnancy rate per woman | 28 per 1000 | 39 per 1000 (9 to 157) | OR 1.41 (0.31 to 6.48) | 209 (1 study) | ⊕⊝⊝⊝ very low1,3 | Only 7 events |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; FET: frozen‐thawed embryo transfer; HMG: human menopausal gonadotrophin; HT: hormone therapy; 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 for serious risk of bias: study at unclear risk of bias in all domains. 2Downgraded two levels due to very serious imprecision: single study, few events. Confidence intervals compatible with benefit in the HMG‐only group or with no clinically meaningful effect. 3Downgraded two levels due to very serious imprecision: single study, very few events. Confidence intervals compatible with benefit in either group or with no effect.