Ashrafinia 2009.

Methods	Prospective randomised trial conducted in Iran from March 2006 to February 2008
Participants	126 women attending a fertility clinic aged 15 to 45 years with a history of infertility for at least 1 year and 3 treatment cycles of clomiphene citrate with no response. Mean age of women in LOD group was 26.54 ± 4.72 years and in the metformin group was 25.13 ± 3.47 years Inclusion: Irregular menstruation, clinical and biochemical signs of hyperandrogenism, polycystic ovaries Exclusion: Diseases that would disturb clinical and hormonal responses, pregnancy during follow‐up, BMI > 30 or < 17
Interventions	LOD performed 4 times in each ovary (n = 63), versus Metformin 1500 g daily (n = 63) Follow‐up for 6 months
Outcomes	Menstrual regularity, hormonal levels, Ferriman‐Gallwey score
Notes	No conflict of interest We have contacted authors for obstetric outcomes Clinical trial registration number: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No details in paper
Allocation concealment (selection bias)	Low risk	Quote: "serially numbered opaque envelopes"
Blinding of participants and personnel (performance bias) All outcomes	High risk	There was no evidence that participants or researchers were blinded
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No details
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants appear to have been followed through the study and all those randomised were analysed
Selective reporting (reporting bias)	Unclear risk	We could not retrieve the original protocol. All outcomes mentioned in the Method section are presented in the Results. There are no reproductive outcomes. Authors have been contacted.
Other bias	Low risk	No evidence of other risk of bias