Ibrahim 2017.
| Methods | Randomised controlled trial conducted in Minia University Hospital, El‐Minia, Egypt Timing: August 2015 to March 2016 |
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| Participants | 80 women randomised and analysed (40 per group); Mean age: Group A: 28.8 ± 3.13; Group B: 29.7 ± 3.65 Inclusion criteria: Between 20 and 35 years of age, diagnosis of PCOS based on the Revised 2003 Consensus Diagnostic Criteria for PCOS (must meet 2 of the 3 following criteria: ultrasound diagnosis of polycystic ovaries, oligo‐ or anovulation clinically diagnosed as oligo‐ or amenorrhoea, and clinical and biochemical hyperandrogenism), normal hysterosalpingogram, partner has normal semen analysis Exclusion criteria: Age < 20 or > 35 years, non‐PCOS, hyperprolactinaemia, hypo‐ and hyperthyroidism, diabetes, Cushing's syndrome, current or previous (within last 6 months) non‐classical congenital adrenal hyperplasia, use of oral contraceptives, glucocorticoids, antiandrogens, antidiabetic or anti‐obesity drugs or any other hormonal drugs, any neoplastic, metabolic, hepatic or cardiovascular disorder or other concurrent medical illness, pelvic diseases, previous pelvic surgery, suspected peritoneal factor infertility, tubal infertility, male‐factor infertility |
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| Interventions | Laparoscopic ovarian drilling (n = 40), versus Letrozole 2.5 mg orally twice daily for 5 days from the 3rd day of menses, repeated for up to 6 cycles if ovulation failed (n = 40) Follow‐up for 6 months |
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| Outcomes | Ovulation rate, pregnancy rate | |
| Notes | No conflict of interest No funding Clinical trial registration number: not stated We requested further information on methods from the authors on 03 August 2017 |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Randomisation was achieved by the use of a randomisation number allocated prior to dosing |
| Allocation concealment (selection bias) | Low risk | Randomisation schedule was produced by an interactive voice response system vendor |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Once the participants had been allocated to 1 of the 2 groups, the treatment was revealed to the investigator |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | The doctor responsible for performing the transvaginal ultrasound follow‐up assessment was blinded to the treatment groups |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | In the Results there was no loss to follow‐up |
| Selective reporting (reporting bias) | Unclear risk | We could not retrieve the original protocol. Outcomes in the Method section were reported in the Results section |
| Other bias | Low risk | No evidence of other risk of bias |