Liu 2015.
| Methods | Parallel randomised controlled trial conducted in Centre for Reproductive Medicine, Tongji University, China Timing: Not stated |
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| Participants | 141 women randomised. Mean age of women in the LOD group 28.1 ± 3.6 years and in the letrozole group was 29.5 ± 3.3 years Inclusion criteria: Diagnosed with PCOS (Revised 2003 Consensus Diagnostic Criteria for PCOS); clomiphene resistance, patent fallopian tubes, normal semen analysis for partner, normal serum prolactin, TSH and 17‐OH progesterone; no systemic disease; no gonadotropin or other hormonal drug treatment during preceding 3 months, normal blood count and blood chemistry; normal glucose and urinalysis Exclusion criteria: Infertility for other reasons than PCOS; uterine cavity lesions or ovarian cyst; > 40 years of age; BMI > 26 kg/m2; contraindications to general anaesthesia; history of pelvic surgery; other endocrine diseases; or a history of liver or renal disease |
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| Interventions | LOD: Both ovaries cauterised at 4 to 6 points, each for 4 seconds at 40 W at a depth of 7 to 8 mm and a diameter of 3 to 5 mm using a monopolar electrosurgical needle (n = 70), versus Letrozole 2.5 mg orally administered on the 5th day of menses and then every day for 5 days. Treatment was repeated for up to 6 cycles (n = 71). Follow‐up for 6 months. Natural intercourse advised |
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| Outcomes | Ovulation, biochemical pregnancy, clinical pregnancy | |
| Notes | Conflict of interest: not stated Clinical trial registration number: not stated |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Quote: "randomly allocated" Comment: no other details. |
| Allocation concealment (selection bias) | Unclear risk | No details |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Once the allocation had been made the intervention 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 | 141 women randomised and 141 women analysed |
| Selective reporting (reporting bias) | High risk | Live birth and spontaneous abortion were reported as outcomes, but not prespecified in the Methods |
| Other bias | Low risk | Groups balanced at baseline. No other bias identified |