Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,510 questions · 2,653 findings · 194 reviews · Gynaecology and Fertility

No studies found 531 · 20%GRADE not reported 76 · 2.9%Very low 826 · 31.1%Low 855 · 32.2%Moderate 341 · 12.9%High 24 · 0.9%

LOD vs other surgical interventions

Harms: Adhesions at 6 months ‐ LOD vs THL N of participants: 246 (1 RCT) · Women with symptoms of PCOS

It is very uncertain whether LOD changes harms: Adhesions at 6 months ‐ LOD vs THL N of participants: 246 (1… compared with other surgical interventions (very low certainty).

1 finding from 1 review

LOD 4‐5 vs 2 or fewer punctures

Menstrual regularity at 12 months Laser LOD vs harmonic scalpel N of participants: 34 (1 RCT) · Women with symptoms of PCOS

LOD 4‐5 may leads to higher menstrual regularity at 6 months ‐ LOD 4 ‐ 5 coagulation points… compared with 2 or fewer punctures (low certainty).

2 findings from 1 review

LOD vs LOD variable energy

Menstrual regularity at 12 months Laser LOD vs harmonic scalpel N of participants: 34 (1 RCT) · Women with symptoms of PCOS

It is very uncertain whether LOD changes menstrual regularity at 3 months ‐ LOD unipolar vs LOD bipolar N of… compared with LOD variable energy (very low certainty).

1 finding from 1 review

LOD vs medical interventions

Improvement in androgenic symptoms · Women with symptoms of PCOS

LOD showed no clear difference in improvement in androgenic symptoms at 6 months (hirsutism/acne) ‐… compared with medical interventions (low certainty).

2 findings from 1 review

LOD vs medical interventions

Harms: GI Upset at 6 months ‐ LOD vs metformin + clomiphene N of participants: 332 (2 RCTs) Harms: OHSS rates at 6 months ‐ LOD vs gonadotrophins N of participants: 33 (1 RCT) · Women with symptoms of PCOS

LOD probably leads to lower harms: GI Upset at 6 months ‐ LOD vs metformin + clomiphene N of… compared with medical interventions (moderate certainty).

1 finding from 1 review

LOD vs other surgical interventions

Menstrual regularity at 12 months Laser LOD vs harmonic scalpel N of participants: 34 (1 RCT) · Women with symptoms of PCOS

LOD showed no clear difference in menstrual regularity at 6 months ‐ LOD vs ultrasound‐guided… compared with other surgical interventions (low certainty).

2 findings from 1 review

LOD vs other surgical interventions

Improvement in androgenic symptoms at 6 months (Acne) ‐ LOD vs USS guided N of participants:31 (1 RCT) · Women with symptoms of PCOS

LOD showed no clear difference in improvement in androgenic symptoms at 6 months (Acne) ‐ LOD vs USS… compared with other surgical interventions (low certainty).

1 finding from 1 review

LOD vs other surgical interventions

Improvement in androgenic symptoms at 6 months (Hirsutism) ‐ LOD vs USS‐guided N of participants: 39 (1 RCT) · Women with symptoms of PCOS

LOD showed no clear difference in improvement in androgenic symptoms at 6 months (Hirsutism) ‐ LOD vs… compared with other surgical interventions (low certainty).

1 finding from 1 review