Cochrane · systematic review · CD009517
Endometrial injury in women undergoing in vitro fertilisation (IVF)
Lensen, SF, Armstrong, S, Gibreel, A, et al. · Cochrane Database of Systematic Reviews · 2021 · 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
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 5 · 41.7%Low 4 · 33.3%Moderate 3 · 25%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 onlyEndometrial injury compared to control in women undergoing assisted reproductive techniques
Population: women undergoing assisted reproductive techniques
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per woman randomised (studies at low risk of selection bias and other bias) Endometrial injury vs control | OR 1.12 [0.98, 1.28] | 8 studies · 4402 participants | Moderate Downgraded: imprecision |
Live birth per woman randomised: sensitivity analysis (no high risk) Endometrial injury vs control | OR 1.13 [0.63, 2.03] | 1 study · 229 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Live birth per woman randomised: sensitivity analysis (including all studies) Endometrial injury vs control | no estimate extracted | 29 studies · 7792 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Miscarriage per woman randomised (studies at low risk of selection bias and other bias) Endometrial injury vs control | OR 0.88 [0.68, 1.13] | 8 studies · 4402 participants | Moderate Downgraded: imprecision |
Miscarriage per woman randomised: sensitivity analysis (no high risk) Endometrial injury vs control | OR 1.17 [0.38, 3.58] | 1 study · 229 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Miscarriage per woman randomised: sensitivity analysis (including all studies) Endometrial injury vs control | OR 1.03 [0.85, 1.25] | 30 studies · 8092 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Clinical pregnancy per woman randomised (studies at low risk of selection bias and other bias) Endometrial injury vs control | OR 1.08 [0.95, 1.23] | 8 studies · 4402 participants | Moderate Downgraded: imprecision |
Clinical pregnancy per woman randomised: sensitivity analysis (no high‐risk) Endometrial injury vs control | OR 1.16 [0.67, 2.02] | 1 study · 229 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Clinical pregnancy per woman randomised: sensitivity analysis (including all studies) Endometrial injury vs control | no estimate extracted | 37 studies · 8786 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Higher compared to lower degree of injury in women undergoing assisted reproductive techniques
Population: women undergoing assisted reproductive techniques
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per woman randomised: sensitivity analysis (including all studies) Higher vs lower degree of injury | OR 1.28 [0.31, 5.37] | 1 study · 129 participants | Very low Downgraded: risk of bias |
Miscarriage per woman randomised: sensitivity analysis (including all studies) Higher vs lower degree of injury | OR 1.28 [0.31, 5.37] | 1 study · 129 participants | Very low Downgraded: risk of bias |
Clinical pregnancy per woman randomised: sensitivity analysis (including all studies) Higher vs lower degree of injury | OR 1.31 [0.46, 3.73] | 1 study · 129 participants | Very low Downgraded: risk of bias |
Effect of endometrial injury performed between day 7 of the previous cycle and day 7 of the ET cycle vs no injury
Population: subfertile women undergoing IVF/ICSI
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth/Ongoing pregnancy per randomly assigned woman Effect of endometrial injury performed between day 7 of the previous cycle and day 7 of the ET cycle vs no injury | RR 1.42 | 9 studies · 1496 participants | Moderate Downgraded: imprecision |
Clinical pregnancy per randomly assigned woman Effect of endometrial injury performed between day 7 of the previous cycle and day 7 of the ET cycle vs no injury | RR 1.34 | 13 studies · 1972 participants | Moderate Downgraded: imprecision |
Miscarriage per clinical pregnancy Effect of endometrial injury performed between day 7 of the previous cycle and day 7 of the ET cycle vs no injury | RR 0.99 | 8 studies · 500 participants | Low Downgraded: risk of bias, imprecision |
Effect of endometrial injury on the day of oocyte retrieval vs no injury
Population: subfertile women undergoing IVF/ICSI
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per randomly assigned woman Effect of endometrial injury on the day of oocyte retrieval vs no injury | RR 0.31 | 1 study · 156 participants | Low Downgraded: imprecision |
Clinical pregnancy per randomly assigned woman Effect of endometrial injury on the day of oocyte retrieval vs no injury | RR 0.36 | 1 study · 156 participants | Low Downgraded: imprecision |
Endometrial injury in the previous cycle
Population: women undergoing ART
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth per allocated woman | OR 2.46 [1.28, 4.72] | 2 studies · 200 participants | Moderate Downgraded: imprecision |
Clinical pregnancy per allocated woman | OR 2.61 [1.71, 3.97] | 4 studies · 435 participants | Moderate Downgraded: imprecision |
Miscarriage per clinical pregnancy | OR 1.13 [0.17, 7.45] | 1 study · 23 participants | Very low Downgraded: imprecision |
Multiple pregnancy per clinical pregnancy | OR 0.87 [0.23, 3.3] | 1 study · 46 participants | Very low Downgraded: imprecision |
Endometrial injury on the day of oocyte retrieval
Population: Women undergoing ART
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ongoing pregnancy per allocated woman | OR 0.28 [0.13, 0.61] | 1 study · 156 participants | Low Downgraded: imprecision |
Clinical pregnancy per allocated woman | OR 0.3 [0.14, 0.63] | 1 study · 156 participants | Low Downgraded: imprecision |