Zakherah 2010.

Methods	Randomised trial conducted in Egypt Timing: January 2007 to February 2009
Participants	150 women with clomiphene‐resistant PCOS attending an infertility clinic. Mean age for CC + tamoxifen group 25.6 ± 3.5 years, LOD group 25.6 ± 4.1 years Inclusion: Age between 18 and 38 years, at least 2 years of primary or secondary infertility due to anovulation, patent fallopian tubes on hysterosalpingography or diagnostic laparoscopy, no hormonal treatment in previous 3 months and normal semen values
Interventions	CC (150 mg) + tamoxifen (40 mg) from day 3 to day 7 for a maximum of 6 consecutive cycles (n = 75), versus LOD performed through triple‐puncture laparoscopy (4 to 6 puncture points were made through the ovarian capsule of each ovary) (n = 75) Follow‐up for 6 months
Outcomes	Pregnancy (biochemical, clinical, live birth), miscarriage, endometrial thickness, ovulation rate (follicles ≥ 18 mm)
Notes	No conflicts of interest Clinical trial registration number: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Using a computer generated random number table.."
Allocation concealment (selection bias)	Unclear risk	Quote: "sealed envelopes" Comment: Not clear if opaque and serially numbered
Blinding of participants and personnel (performance bias) All outcomes	High risk	No details provided but unlikely that there was blinding
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No details provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	There was no loss to follow‐up and all 150 women were analysed
Selective reporting (reporting bias)	Unclear risk	We could not retrieve the original protocol. All a priori outcomes in paper were reported
Other bias	Low risk	No evidence of other risk of bias