Summary of findings 2. Operative hysteroscopy versus control in women undergoing medically assisted reproduction with suspected major uterine cavity abnormalities.
| Operative hysteroscopy versus control in women undergoing medically assisted reproduction with suspected major uterine cavity abnormalities | ||||||
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Patient or population: subfertile women with endometrial polyps diagnosed by ultrasonography prior to treatment with gonadotropin and intrauterine insemination Settings: infertility unit of a university tertiary hospital in Madrid, Spain Intervention: hysteroscopic polypectomy using a 5.5 mm continuous flow office hysteroscope with a 1.5 mm scissors and forceps Comparison: diagnostic hysteroscopy using a 5.5 mm continuous flow office hysteroscope and polyp biopsy | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Polypectomy | |||||
| Live birth | No data reported. | |||||
| Adverse events: hysteroscopy complications | No data reported. | |||||
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Clinical pregnancya Ultrasound 4 intrauterine insemination cycles |
282 per 1000 | 634 per 1000 (451 to 894) |
OR 4.41 (2.45 to 7.96) |
204 (1 study) | ⊕⊕⊝⊝ Lowb,c | — |
| Adverse events: miscarriage | No data were reported for this secondary outcome. | |||||
| *The basis for the assumed risk is the control group risk of the single included study (Pérez‐Medina 2005). 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; OR: odds ratio. | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
aClinical pregnancy was defined by the presence of at least one gestational sac on ultrasound.
bDowngraded by one level for serious risk of bias (high risk for selective outcome reporting).
cDowngraded by one level for serious imprecision (wide confidence interval of the effect size estimate).