Summary of findings 1. Assisted hatching compared to no assisted hatching for women undergoing assisted conception.
| Assisted hatching compared to no assisted hatching for women undergoing assisted conception | ||||||
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Patient or population: women undergoing assisted conception Setting: clinic Intervention: assisted hatching Comparison: no assisted hatching | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | №. of participants (studies) | Quality of evidence (GRADE) | Comments | |
| Risk with no assisted hatching | Risk with assisted hatching | |||||
| Live births per woman randomised | 283 per 1000 | 301 per 1000 (267 to 338) | OR 1.09 (0.92 to 1.29) | 2849 (14 RCTs) | ⊕⊕⊝⊝ LOWa | |
| Multiple pregnancy rate per woman randomised | 91 per 1000 | 121 per 1000 (102 to 144) | OR 1.38 (1.13 to 1.68) | 4308 (18 RCTs) | ⊕⊕⊝⊝ LOWb | |
| Clinical pregnancy rate per woman randomised | 322 per 1000 | 363 per 1000 (341 to 387) | OR 1.20 (1.09 to 1.33) | 7249 (39 RCTs) | ⊕⊕⊝⊝ LOWb | |
| Miscarriage rate per woman randomised | 53 per 1000 | 60 per 1000 (44 to 81) | OR 1.13 (0.82 to 1.56) | 2810 (17 RCTs) | ⊕⊝⊝⊝ VERY LOWc | |
| *The risk in the intervention group (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; RCT: randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence. High quality: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded two levels for serious risk of bias and publication bias: in many studies, the method was unclear and information was incomplete. The main limitation was serious risk of bias associated with poor reporting of study methods.
bDowngraded two levels for serious risk of bias and for serious inconsistency.
cDowngraded three levels for serious risk of bias, serious inconsistency, and serious imprecision (only 158 events).