Cochrane · systematic review · CD002249
Clomiphene and other antioestrogens for ovulation induction in polycystic ovarian syndrome
Brown, J, Farquhar, C · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
22
current version
GRADE rated
17
No studies
4
Included studies
NR
No studies 4 · 18.2%Ungraded 1 · 4.5%Very low 9 · 40.9%Low 8 · 36.4%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antioestrogen versus placebo
Population: ovulation induction in polycystic ovarian syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate ‐ not reported Antioestrogen vs placebo | no estimate extracted | NR | No studies |
Miscarriage rate ‐ not reported Antioestrogen vs placebo | no estimate extracted | NR | No studies |
Clinical pregnancy rate Antioestrogen vs placebo | OR 5.91 [1.77, 19.68] | 3 studies · 133 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate ‐ not reported Antioestrogen vs placebo | no estimate extracted | NR | No studies |
Ovarian hyperstimulation syndrome (OHSS) ‐ not reported Antioestrogen vs placebo | no estimate extracted | NR | No studies |
Antioestrogen versus antioestrogen
Population: ovulation induction in polycystic ovarian syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clomiphene citrate versus tamoxifen ‐ Live birth rate Antioestrogen vs antioestrogen | OR 1.24 [0.59, 2.62] | 2 studies · 195 participants | Low Downgraded: imprecision |
Clomiphene citrate versus tamoxifen ‐ Miscarriage rate Antioestrogen vs antioestrogen | OR 1.81 [0.8, 4.12] | 4 studies · 653 participants | Low Downgraded: risk of bias, imprecision |
Clomiphene citrate versus tamoxifen ‐ Clinical pregnancy rate Antioestrogen vs antioestrogen | OR 1.3 [0.92, 1.85] | 5 studies · 757 participants | Low Downgraded: risk of bias |
Clomiphene citrate versus tamoxifen ‐ Multiple pregnancy Antioestrogen vs antioestrogen | OR 2.34 [0.34, 16.04] | 3 studies · 567 participants | Very low Downgraded: risk of bias, imprecision |
Clomiphene citrate versus tamoxifen ‐ ovarian hyperstimulation syndrome (OHSS) Antioestrogen vs antioestrogen | no estimate extracted | 3 studies · 567 participants | Ungraded |
Clomiphene citrate plus tamoxifen versus clomiphene citrate ‐ Clinical pregnancy rate Antioestrogen vs antioestrogen | OR 3.32 [0.12, 91.6] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Antioestrogen plus medical adjunct versus antioestrogen alone
Population: ovulation induction in polycystic ovarian syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clomiphene citrate plus ketoconazole versus clomiphene citrate Antioestrogen plus medical adjunct vs antioestrogen alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Clomiphene citrate plus bromocriptine versus clomiphene citrate ‐ Clinical pregnancy rate Antioestrogen plus medical adjunct vs antioestrogen alone | OR 1.03 [0.48, 2.21] | 2 studies · 174 participants | Low Downgraded: risk of bias, imprecision |
Clomiphene citrate plus dexamethasone versus clomiphene citrate Antioestrogen plus medical adjunct vs antioestrogen alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Clomiphene citrate plus combined oral contraceptive versus clomiphene citrate ‐ Miscarriage rate Antioestrogen plus medical adjunct vs antioestrogen alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Clomiphene citrate plus hCG versus clomiphene citrate alone Antioestrogen plus medical adjunct vs antioestrogen alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Clomiphene citrate plus hormone supplementation versus clomiphene citrate alone Antioestrogen plus medical adjunct vs antioestrogen alone | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Antioestrogen regimens
Population: ovulation induction in polycystic ovarian syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth ‐ Clomiphene citrate 5 days versus clomiphene citrate 10 days | OR 0.1 [0.02, 0.45] | 1 study · 220 participants | Low Downgraded: imprecision |
Clinical pregnancy ‐ Clomiphene citrate 5 days versus clomiphene citrate 10 days | OR 0.18 [0.06, 0.55] | 1 study · 220 participants | Low Downgraded: imprecision |
Multiple pregnancy ‐ Clomiphene citrate 5 days versus clomiphene citrate 10 days | OR 0.33 [0.03, 3.2] | 1 study · 220 participants | Very low Downgraded: imprecision |
Miscarriage rate ‐ Early versus late clomiphene citrate | OR 1.25 [0.27, 5.7] | 1 study · 212 participants | Very low Downgraded: risk of bias, imprecision |
Clinical pregnancy ‐ Early versus late clomiphene citrate | OR 2.81 [1.02, 7.75] | 1 study · 78 participants | Low Downgraded: imprecision |