Findings

What do systematic reviews say?

21 questions · 21 findings · 11 reviews · Gynaecology and Fertility

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No studies found 5 · 23.8%GRADE not reported 0 · 0%Very low 7 · 33.3%Low 6 · 28.6%Moderate 3 · 14.3%High 0 · 0%

Modified natural cycle FET (HCG trigger) vs HT + GnRHa FET

Multiple pregnancy rate · subfertile women

The review found no eligible studies for this question.

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Natural cycle FET vs HT + GnRHa FET

Multiple pregnancy rate · subfertile women

Natural cycle FET showed no clear difference in multiple pregnancy rate per woman compared with HT plus GnRHa suppression FET (low certainty).

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
OR 0.58 [0.13, 2.5]
1 study · 159 participants
Low

Progesterone vs no treatment or placebo (route of progesterone administration)

Multiple pregnancy rate · women trying to conceive by intrauterine insemination

Progesterone showed no clear difference in multiple pregnancy per woman compared with no treatment or placebo (route of progesterone administration) (low certainty).

1 finding from 1 review

Luteal phase support for women trying to conceive by intrauterine insemination or sexual intercourse 2022 · Cochrane Headline outcomes only
RR 0.84 [0.3, 2.34]
3 studies · 956 participants
Low

Natural cycle FET vs modified natural cycle FET (HCG trigger)

Multiple pregnancy rate · subfertile women

The review found no eligible studies for this question.

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Natural cycle IVF vs standard IVF

Multiple pregnancy rate · stimulated cycles for subfertile couples

It is very uncertain whether natural cycle IVF changes multiple pregnancy per woman compared with standard IVF (very low certainty).

1 finding from 1 review

Natural cycle in vitro fertilisation (IVF) for subfertile couples 2013 · Cochrane Headline outcomes only
OR 0.76 [0.25, 2.31]
2 studies · 527 participants
Very low

Modified natural cycle FET (HCG trigger) vs HT FET

Multiple pregnancy rate · subfertile women

The review found no eligible studies for this question.

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

HT FET vs HT + GnRHa FET

Multiple pregnancy rate · women with primary or secondary subfertility

The review found no eligible studies for this question.

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

HMG FET vs clomiphene + HMG FET

Multiple pregnancy rate · subfertile women

It is very uncertain whether HMG FET changes multiple pregnancy rate per woman compared with clomiphene + HMG FET (very low certainty).

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
OR 1.41 [0.31, 6.48]
1 study · 209 participants
Very low

Natural cycle FET vs HT FET

Multiple pregnancy rate · subfertile women

It is very uncertain whether natural cycle FET changes multiple pregnancy rate per woman compared with HT FET (very low certainty).

1 finding from 1 review

Cycle regimens for frozen‐thawed embryo transfer 2017 · Cochrane Headline outcomes only
OR 2.48 [0.09, 68.14]
1 study · 21 participants
Very low

Day 3 vs Day 2 embryo transfer following IVF or ICSI

Multiple pregnancy rate · Women undergoing in vitro fertilisation or intracytoplasmic sperm injection

Day 3 showed no clear difference in multiple pregnancy rate per woman compared with day 2 embryo transfer following IVF or ICSI (moderate certainty).

1 finding from 1 review

Day three versus day two embryo transfer following in vitro fertilization or intracytoplasmic sperm injection 2016 · Cochrane Headline outcomes only
RR 1.12 [0.86, 1.44]
8 studies · 1837 participants
Moderate

Ultrasound‐guided transvaginal ovarian needle drilling with gonadotropin (Gn) vs Gn

Multiple pregnancy rate · clomiphene‐resistant polycystic ovarian syndrome in subfertile women

It is very uncertain whether ultrasound‐guided transvaginal ovarian needle drilling with… changes multiple pregnancy rate (per woman) compared with gn (very low certainty).

1 finding from 1 review

Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in… 2019 · Cochrane Headline outcomes only
OR 1.25 [0.27, 5.77]
2 studies · 155 participants
Very low

Metformin vs placebo co‐treatment

Multiple pregnancy rate · subfertile women with polycystic ovary syndrome

Metformin showed no clear difference in multiple pregnancy rate (per woman) compared with placebo co‐treatment (low certainty).

1 finding from 1 review

Metformin during ovulation induction with gonadotrophins followed by timed intercourse or intrauterine insemination… 2017 · Cochrane Headline outcomes only
OR 0.55 [0.15, 1.95]
4 studies · 232 participants
Low

Glucocorticoid supplementation vs placebo

Multiple pregnancy rate · Women undergoing IVF/ICSI cycles

It is very uncertain whether glucocorticoid supplementation changes multiple pregnancy rate per woman/couple compared with placebo (very low certainty).

1 finding from 1 review

Glucocorticoid supplementation during ovarian stimulation for IVF or ICSI 2017 · Cochrane Headline outcomes only
OR 3.32 [0.12, 91.6]
1 study · 20 participants
Very low

Gonadotrophins vs continued clomiphene citrate

Multiple pregnancy rate · anovulatory women with clomiphene citrate‐failure

Gonadotrophins showed no clear difference in incidence of multiple pregnancy per woman compared with continued clomiphene citrate (moderate certainty).

1 finding from 1 review

Gonadotrophins for ovulation induction in women with polycystic ovary syndrome 2019 · Cochrane Headline outcomes only
RR 0.89 [0.33, 2.4]
1 study · 661 participants
Moderate

Ultrasound‐guided embryo transfer vs clinical touch

Multiple pregnancy rate · Women undergoing embryo transfer as part of IVF or ICSI cycle

Ultrasound‐guided embryo transfer showed no clear difference in multiple pregnancy (per woman randomised) compared with clinical touch (moderate certainty).

1 finding from 1 review

Ultrasound versus 'clinical touch' for catheter guidance during embryo transfer in women 2016 · Cochrane Headline outcomes only
OR 1.13 [0.87, 1.45]
8 studies · 3379 participants
Moderate

Recombinant follicle stimulating hormone vs urinary‐derived gonadotrophins

Multiple pregnancy rate · ovulation induction in polycystic ovarian syndrome

Recombinant follicle stimulating hormone showed no clear difference in incidence of multiple pregnancy (per woman) compared with urinary‐derived gonadotrophins (low certainty).

1 finding from 1 review

Gonadotrophins for ovulation induction in women with polycystic ovary syndrome 2019 · Cochrane Headline outcomes only
RR 0.86 [0.46, 1.61]
8 studies · 1368 participants
Low

Human menopausal gonadotrophin or highly purified human menopausal gonadotrophin vs urinary follicle stimulating hormone

Multiple pregnancy rate · ovulation induction in polycystic ovarian syndrome

It is very uncertain whether human menopausal gonadotrophin or highly purified human menopausal… changes incidence of multiple pregnancy (per woman) compared with urinary follicle stimulating hormone (very low certainty).

1 finding from 1 review

Gonadotrophins for ovulation induction in women with polycystic ovary syndrome 2019 · Cochrane Headline outcomes only
RR 2.13 [0.51, 8.91]
4 studies · 161 participants
Very low

IVF vs IUI + ovarian stimulation with gonadotropins or CC

Multiple pregnancy rate · women with unexplained subfertility

IVF showed no clear difference in multiple pregnancy rate per woman randomised compared with IUI + ovarian stimulation with gonadotropins or CC (low certainty).

1 finding from 1 review

In vitro fertilisation for unexplained subfertility 2023 · Cochrane Headline outcomes only
OR 0.82 [0.38, 1.77]
3 studies · 731 participants
Low

IVF vs expectant management

Multiple pregnancy rate · women with unexplained subfertility

The review found no eligible studies for this question.

1 finding from 1 review

In vitro fertilisation for unexplained subfertility 2023 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

IVF vs unstimulated IUI

Multiple pregnancy rate · women with unexplained subfertility

It is very uncertain whether IVF changes multiple pregnancy rate per woman randomised compared with unstimulated IUI (very low certainty).

1 finding from 1 review

In vitro fertilisation for unexplained subfertility 2023 · Cochrane Headline outcomes only
OR 1.03 [0.04, 27.29]
1 study · 43 participants
Very low