What do systematic reviews say?

Misoprostol vs placebo or no treatment before operative hysteroscopy

Misoprostol probably leads to lower intraoperative complications compared with placebo or no treatment before operative hysteroscopy (moderate certainty).

• Preoperative ripening of the cervix before operative hysteroscopy 2015 · Cochrane Headline outcomes only
  OR 0.37 [0.18, 0.77]
  12 studies · 901 participants
  Moderate

Misoprostol vs placebo or no treatment before operative hysteroscopy

Misoprostol probably leads to lower specific intraoperative complications ‐ Cervical laceration/tear compared with placebo or no treatment before operative hysteroscopy (moderate certainty).

• Preoperative ripening of the cervix before operative hysteroscopy 2015 · Cochrane Headline outcomes only
  OR 0.25 [0.11, 0.57]
  9 studies · 669 participants
  Moderate

Misoprostol vs placebo or no treatment before operative hysteroscopy

Misoprostol probably leads to lower specific intraoperative complications ‐ False track compared with placebo or no treatment before operative hysteroscopy (moderate certainty).

• Preoperative ripening of the cervix before operative hysteroscopy 2015 · Cochrane Headline outcomes only
  OR 0.34 [0.12, 0.97]
  7 studies · 560 participants
  Moderate

Misoprostol vs placebo or no treatment before operative hysteroscopy

Misoprostol showed no clear difference in specific intraoperative complications ‐ Uterine perforation compared with placebo or no treatment before operative hysteroscopy (low certainty).

• Preoperative ripening of the cervix before operative hysteroscopy 2015 · Cochrane Headline outcomes only
  OR 0.42 [0.13, 1.38]
  7 studies · 455 participants
  Low

Misoprostol vs placebo or no treatment before operative hysteroscopy

Misoprostol showed no clear difference in specific intraoperative complications ‐ Uterine bleeding compared with placebo or no treatment before operative hysteroscopy (low certainty).

• Preoperative ripening of the cervix before operative hysteroscopy 2015 · Cochrane Headline outcomes only
  OR 0.51 [0.1, 2.49]
  4 studies · 340 participants
  Low

Misoprostol vs placebo or no treatment before operative hysteroscopy

Misoprostol probably leads to higher side effects compared with placebo or no treatment before operative hysteroscopy (moderate certainty).

• Preoperative ripening of the cervix before operative hysteroscopy 2015 · Cochrane Headline outcomes only
  OR 2.59 [1.15, 5.79]
  4 studies · 272 participants
  Moderate

Primary outcome: topical local anaesthetics vs placebo or no treatment

• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  9 studies · 613 participants
  Low
• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 373 participants
  Very low
• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 166 participants
  Very low

Locally injected anaesthetics vs placebo or no treatment

• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 125 participants
  Low
• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 125 participants
  Low

Oral opioid analgesics vs placebo or no treatment

• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 128 participants
  Low
• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 128 participants
  Moderate

Intravenous opioid analgesics vs placebo or no treatment

• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 62 participants
  Moderate

Oral non‐opioid analgesics vs placebo or no treatment

• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 133 participants
  Low
• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 45 participants
  Very low
• Pain relief in hysterosalpingography 2015 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 133 participants
  Low

hCG vs placebo/no treatment

It is very uncertain whether hCG changes live birth or ongoing pregnancy compared with placebo/no treatment (very low certainty).

• Luteal phase support for assisted reproduction cycles 2015 · Cochrane Headline outcomes only
  OR 1.76 [1.08, 2.86]
  3 studies · 527 participants
  Very low

hCG vs placebo/no treatment

It is very uncertain whether hCG changes clinical pregnancy compared with placebo/no treatment (very low certainty).

• Luteal phase support for assisted reproduction cycles 2015 · Cochrane Headline outcomes only
  OR 1.3 [0.9, 1.88]
  5 studies · 746 participants
  Very low

hCG vs placebo/no treatment

hCG may leads to higher OHSS compared with placebo/no treatment (low certainty).

• Luteal phase support for assisted reproduction cycles 2015 · Cochrane Headline outcomes only
  OR 4.28 [1.91, 9.6]
  1 study · 387 participants
  Low

Progesterone vs placebo/no treatment

It is very uncertain whether progesterone changes live birth or ongoing pregnancy compared with placebo/no treatment (very low certainty).

• Luteal phase support for assisted reproduction cycles 2015 · Cochrane Headline outcomes only
  OR 1.77 [1.09, 2.86]
  5 studies · 642 participants
  Very low

Progesterone vs placebo/no treatment

Progesterone may leads to higher clinical pregnancy compared with placebo/no treatment (low certainty).

• Luteal phase support for assisted reproduction cycles 2015 · Cochrane Headline outcomes only
  OR 1.89 [1.3, 2.75]
  7 studies · 841 participants
  Low

Progesterone vs placebo/no treatment

The review found no eligible studies for this question.

• Luteal phase support for assisted reproduction cycles 2015 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

DHEA or testosterone vs placebo/no treatment

DHEA or testosterone probably leads to higher live birth/ongoing pregnancy rate ‐ DHEA compared with placebo/no treatment (moderate certainty).

• Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction 2015 · Cochrane Headline outcomes only
  OR 1.81 [1.25, 2.62]
  8 studies · 878 participants
  Moderate
• Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction 2015 · Cochrane Headline outcomes only
  OR 2.6 [1.3, 5.2]
  4 studies · 345 participants
  Moderate

DHEA or testosterone vs placebo/no treatment

DHEA or testosterone showed no clear difference in miscarriage rate ‐ DHEA compared with placebo/no treatment (moderate certainty).

• Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction 2015 · Cochrane Headline outcomes only
  OR 0.58 [0.29, 1.17]
  8 studies · 950 participants
  Moderate

DHEA or testosterone vs placebo/no treatment

DHEA or testosterone showed no clear difference in miscarriage rate ‐ Testosterone compared with placebo/no treatment (low certainty).

• Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction 2015 · Cochrane Headline outcomes only
  OR 2.04 [0.58, 7.13]
  4 studies · 345 participants
  Low