Table 2. GRADE quality assessment for comparison 1: Comparing clomiphene citrate plus LC versus clomiphene citrate plus placebo.

Certainty assessment						Number of patients		Effect		Certainty
Total study	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	LC + CC	CC + placebo	Relative (95% CI)	Absolute (95% CI)
Outcome: Clinical pregnancy rate
2 RCTs	not serious	seriousa	not serious	seriousb	none	46/132 (34.8%)	4/132 (3.0%)	RR 7.12 (0.14 to 350.06)	185 more per 1,000 (from 26 fewer to 1,000 more)	$⨁⨁○○$ LOW
Outcome: Ovulation rate
2 RCTs	not serious	seriousa	not serious	seriousb	none	88/132 (66.7%)	36/132 (27.3%)	RR 2.37 (0.99 to 5.66)	374 more per 1,000 (from 3 fewer to 1,000 more)	$⨁⨁○○$ LOW
Outcome: BMI
1 RCT	not serious	not serious	not serious	seriousc	none	47	47	–	MD 0.4 lower (2.12 lower to 1.32 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Serum FSH
1 RCT	not serious	not serious	not serious	serious c	none	47	47	–	MD 0.1 higher (0.5 lower to 0.7 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Serum LH
1 RCT	not serious	not serious	not serious	serious c	none	47	47	–	MD 0.2 lower (0.91 lower to 0.51 higher)	$⨁⨁⨁○$ MODERATE

Notes.

CI

Confidence interval

RR

Risk ratio

MD

Mean difference

RCT

Randomized controlled trial

GRADE Working Group grades of evidence.

High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.

Moderate certainty: 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 certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.

Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

Explanations

^aheterogeneity >75%.

^bnumber of events<400.

^cnumber of participants <400.