Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

63 questions · 70 findings · 6 reviews · Headline outcomes only

No studies found 12 · 17.1%GRADE not reported 0 · 0%Very low 14 · 20%Low 34 · 48.6%Moderate 10 · 14.3%High 0 · 0%

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 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 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

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