Cochrane · systematic review · CD008528
Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation
Kamath, MS, Maheshwari, A, Bhattacharya, S, 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
11
current version
GRADE rated
11
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 6 · 54.5%Moderate 5 · 45.5%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
Current version onlyClomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) compared to gonadotropins (with GnRH agonists or midcycle antagonist) in IVF and ICSI cycles in general population for controlled ovarian stimulation
Population: for controlled ovarian stimulation
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonists or midcycle antagonist) | RR 0.92 [0.66, 1.27] | 4 studies · 493 participants | Low Downgraded: risk of bias, imprecision |
Ovarian hyperstimulation syndrome per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonists or midcycle antagonist) | Peto OR 0.21 [0.11, 0.41] | 5 studies · 1067 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonists or midcycle antagonist) | RR 1 [0.86, 1.16] | 12 studies · 1998 participants | Moderate Downgraded: risk of bias |
Cancellation rate per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonists or midcycle antagonist) | RR 1.87 [1.43, 2.45] | 9 studies · 1784 participants | Low Downgraded: risk of bias, inconsistency |
Mean number of gonadotropin ampoules used per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonists or midcycle antagonist) | no estimate extracted | 6 studies · 1098 participants | Moderate Downgraded: risk of bias, inconsistency |
Mean number of oocytes retrieved per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonists or midcycle antagonist) | no estimate extracted | 8 studies · 1481 participants | Moderate Downgraded: risk of bias, inconsistency |
Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) compared to gonadotropins (with GnRH agonist or midcycle antagonist) in IVF and ICSI cycles in poor responders for controlled ovarian stimulation
Population: Women undergoing controlled ovarian stimulation in IVF and ICSI cycles (poor responders)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonist or midcycle antagonist) | RR 1.16 [0.49, 2.79] | 2 studies · 357 participants | Low Downgraded: risk of bias, imprecision |
Clinical pregnancy rate per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonist or midcycle antagonist) | RR 0.85 [0.64, 1.12] | 8 studies · 1462 participants | Low Downgraded: risk of bias, imprecision |
Cancellation rate per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonist or midcycle antagonist) | RR 1.46 [1.18, 1.81] | 10 studies · 1601 participants | Low Downgraded: risk of bias, inconsistency |
Mean number of gonadotropin ampoules used per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonist or midcycle antagonist) | no estimate extracted | 3 studies · 136 participants | Moderate Downgraded: risk of bias, inconsistency |
Mean number of oocytes retrieved per woman Clomiphene citrate or letrozole with or without gonadotropins (with or without midcycle antagonist) vs gonadotropins (with GnRH agonist or midcycle antagonist) | no estimate extracted | 8 studies · 1203 participants | Moderate Downgraded: risk of bias, inconsistency |
Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) versus gonadotropins with GnRH agonists protocols in IVF and ICSI cycles
Population: patients with controlled ovarian stimulation in women undergoing in vitro fertilization.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) vs gonadotropins with GnRH agonists protocols | OR 0.93 [0.69, 1.24] | 5 studies · 1079 participants | Low Downgraded: risk of bias |
Ovarian hyperstimulation syndrome Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) vs gonadotropins with GnRH agonists protocols | OR 0.23 [0.1, 0.52] | 5 studies · 1559 participants | Low Downgraded: imprecision |
Clinical pregnancy rate Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) vs gonadotropins with GnRH agonists protocols | OR 1.07 [0.85, 1.33] | 10 studies · 1864 participants | Moderate Downgraded: risk of bias |
cancellation rate Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) vs gonadotropins with GnRH agonists protocols | OR 1.83 [1.39, 2.42] | 11 studies · 1950 participants | Moderate Downgraded: risk of bias, inconsistency |
Mean number of ampoules used Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) vs gonadotropins with GnRH agonists protocols | no estimate extracted | 8 studies · 1413 participants | Moderate Downgraded: risk of bias, inconsistency |
Mean number of oocytes retrieved. Clomiphene citrate with gonadotropins (with or without mid‐cycle GnRH antagonist) vs gonadotropins with GnRH agonists protocols | no estimate extracted | 10 studies · 1860 participants | Moderate Downgraded: risk of bias, inconsistency |