Hashim 2010.
| Methods | A randomised controlled trial | |
| Participants | The study comprised 260 women with CC‐resistant PCOS among those attending the Outpatient Clinic in Mansoura University Hospitals, Mansoura, Egypt, and a private practice setting from August 2006 to March 2009 | |
| Interventions | Group A (n = 128) received 2.5 mg letrozole daily for 5 days for up to 6 cycles. Group B (n = 132) underwent LOD with 6 months follow‐up. In letrozole group (group A), treatment continued for up to 6 cycles. In LOD group (group B), laparoscopy was performed using 3‐puncture technique. Each ovary was cauterised at 4 points, each for 4 seconds at 40 W for a depth of 4 mm with a mixed current, using a monopolar electrosurgical needle. Follow‐up continued for 6 months after the procedure | |
| Outcomes | Resumption of regular menstruation, ovulation rate, pregnancy, miscarriage, live birth rates and midcycle endometrial thickness. No operative complications developed, No multiple pregnancies or OHSS in either group. |
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| Notes | Funding source: Not stated Declarations of interest: "We declare that we have no conflict of interest". | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | "Women were randomized according to a computer‐generated random numeric table prepared by an independent statistician" |
| Allocation concealment (selection bias) | Low risk | "concealment of treatment allocation by use of sealed opaque envelopes that were given to a third party (nurse) who assigned patients to study arms; group A (letrozole) or B (LOD)". |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | "the treatment was revealed to both the investigator and the patient" |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | "the radiologist who performed transvaginal ultrasound follow up assessment was blinded to the treatment groups" |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | No attrition |
| Selective reporting (reporting bias) | Low risk | None detected |
| Other bias | Low risk | None detected |