Summary of findings 2. Letrozole compared to laparoscopic ovarian drilling for infertile women with polycystic ovary syndrome.
| Letrozole compared to laparoscopic ovarian drilling compared to placebo for infertile women with polycystic ovary syndrome | ||||||
| Patient or population: infertile women with polycystic ovary syndrome Setting: (fertility) clinics or outpatient settings Intervention: letrozole with or without adjuncts followed by timed intercourse Comparison: laparoscopic ovarian drilling (LOD) followed by timed intercourse | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (trials) | Certainty of the evidence (GRADE) | Comments | |
| Risk with LOD | Risk with letrozole | |||||
| Live birth rate | 229 per 1000 | 380 per 1000 (227 to 561) | OR 2.07 (0.99 to 4.32) | 141 (1 RCT) | ⊕⊝⊝⊝ Very Lowa,b,c | |
| Ovarian hyperstimulation syndrome rate | No trials reported on this outcome | |||||
| Clinical pregnancy rate | 290 per 1000 | 375 per 1000 (279 to 482) | OR 1.47 (0.95 to 2.28) | 376 (3 RCTs) | ⊕⊕⊝⊝ Lowa,b | |
| Miscarriage rate per pregnancy | 151 per 1000 | 104 per 1000 (38 to 254) | OR 0.65 (0.22 to 1.92) | 122 (3 RCTs) | ⊕⊕⊝⊝ Lowa,b | |
| Multiple pregnancy rate | 0 per 1000 | 0 per 1000 (0 to 0) | OR 3.00 (0.12 to 74.90) | 141 (1 RCT) | ⊕⊝⊝⊝ Very Lowa,b,c | |
| *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 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. | ||||||
aInsufficient data to allow judgement of risk of bias in some trials ‐ downgraded one level for serious risk of bias. bThere is insufficient data to determine if there is a difference as opposed to no evidence of a difference ‐ downgraded one level for imprecision. cAnalysis is based on only one trial ‐ downgraded one additional level for imprecision.