Cochrane · systematic review · CD003053
Insulin‐sensitising drugs (metformin, rosiglitazone, pioglitazone, D‐chiro‐inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility
Morley, LC, Tang, T, Yasmin, E, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
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
21
current version
GRADE rated
18
No studies
3
Included studies
NR
No studies 3 · 14.3%Ungraded 0 · 0%Very low 5 · 23.8%Low 7 · 33.3%Moderate 6 · 28.6%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
Show all 2 versionsMetformin compared to placebo or no treatment for women with polycystic ovary syndrome
Population: women with polycystic ovary syndrome, oligo amenorrhoea and subfertility
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman Metformin vs placebo or no treatment | OR 1.59 [1, 2.51] | 4 studies · 435 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (gastrointestinal) per woman Metformin vs placebo or no treatment | OR 4.76 [3.06, 7.41] | 7 studies · 670 participants | Moderate Downgraded: risk of bias, inconsistency |
Clinical pregnancy rate per woman Metformin vs placebo or no treatment | OR 1.93 [1.42, 2.64] | 9 studies · 1027 participants | Moderate Downgraded: risk of bias |
Menstrual frequency per woman Metformin vs placebo or no treatment | OR 1.72 [1.14, 2.61] | 7 studies · 427 participants | Low Downgraded: risk of bias, inconsistency |
Ovulation rate per woman Metformin vs placebo or no treatment | OR 2.55 [1.81, 3.59] | 14 studies · 701 participants | Moderate Downgraded: risk of bias |
Miscarriage rate per woman Metformin vs placebo or no treatment | OR 1.08 [0.5, 2.35] | 4 studies · 748 participants | Low Downgraded: risk of bias, imprecision |
Metformin combined with clomiphene citrate versus clomiphene citrate alone for women with polycystic ovary syndrome
Population: women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman Metformin combined with clomiphene citrate vs clomiphene citrate alone | OR 1.21 [0.92, 1.59] | 9 studies · 1079 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (gastrointestinal) per woman Metformin combined with clomiphene citrate vs clomiphene citrate alone | OR 3.97 [2.59, 6.08] | 3 studies · 591 participants | Moderate Downgraded: risk of bias |
Clinical pregnancy rate per woman Metformin combined with clomiphene citrate vs clomiphene citrate alone | OR 1.59 [1.27, 1.99] | 16 studies · 1529 participants | Moderate Downgraded: risk of bias |
Menstrual frequency per woman Metformin combined with clomiphene citrate vs clomiphene citrate alone | no estimate extracted | NR | No studies |
Ovulation rate per woman Metformin combined with clomiphene citrate vs clomiphene citrate alone | OR 1.57 [1.28, 1.92] | 21 studies · 1624 participants | Moderate Downgraded: risk of bias, inconsistency |
Miscarriage rate per woman Metformin combined with clomiphene citrate vs clomiphene citrate alone | OR 1.59 [1.03, 2.46] | 9 studies · 1096 participants | Low Downgraded: risk of bias, imprecision |
Metformin compared to clomiphene citrate for women with polycystic ovary syndrome
Population: women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate per woman Participants with BMI < 30 kg/m2 or ≤ 32 kg/m2a Metformin vs clomiphene citrate | OR 1.71 [1, 2.94] | 3 studies · 241 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Live birth rate per woman Participants with BMI ≥ 30 kg/m2a Metformin vs clomiphene citrate | OR 0.3 [0.17, 0.52] | 2 studies · 500 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events (gastrointestinal) Metformin vs clomiphene citrate | no estimate extracted | NR | No studies |
Clinical pregnancy rate per woman Participants with BMI < 30 kg/m2 or ≤ 32 kg/m2a Metformin vs clomiphene citrate | OR 1.56 [1.05, 2.33] | 5 studies · 490 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Clinical pregnancy rate per woman Participants with BMI ≥ 30 kg/m2a Metformin vs clomiphene citrate | OR 0.34 [0.21, 0.55] | 2 studies · 500 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Menstrual frequency Metformin vs clomiphene citrate | no estimate extracted | NR | No studies |
Ovulation rate per woman Participants with BMI < 30 kg/m2b Metformin vs clomiphene citrate | OR 0.81 [0.51, 1.28] | 4 studies · 312 participants | Low Downgraded: risk of bias |
Ovulation rate per woman Participants with BMI ≥ 30 kg/m2b Metformin vs clomiphene citrate | OR 0.29 [0.2, 0.43] | 2 studies · 500 participants | Low Downgraded: risk of bias |
Miscarriage rate per woman Metformin vs clomiphene citrate | OR 0.92 [0.5, 1.67] | 5 studies · 741 participants | Very low Downgraded: risk of bias |