Cochrane · systematic review · CD009526
Ovarian surgery for symptom relief in women with polycystic ovary syndrome
Lepine, S, Jo, J, Metwally, M, et al. · Cochrane Database of Systematic Reviews · 2017 · 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
19
current version
GRADE rated
16
No studies
3
Included studies
NR
No studies 3 · 15.8%Ungraded 0 · 0%Very low 6 · 31.6%Low 8 · 42.1%Moderate 2 · 10.5%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
LOD compared to medical interventions for symptom relief in women with polycystic ovary syndrome
Population: Women with symptoms of PCOS
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual regularity at 6 months LOD vs metformin N of participants: 236 (2 RCTs) LOD vs metformin + clomiphene N of participants: 332 (2 RCTs) LOD vs gonadotropins N of participants: 35 (1 RCT) LOD vs letrozole N of participants: 260 (1 RCT) LOD ... LOD vs medical interventions | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, inconsistency |
Improvement in androgenic symptoms at 6 months (hirsutism/acne) ‐ LOD vs metformin N of participants: 126 (1 RCT) LOD vs medical interventions | OR 1 [0.42, 2.37] | NR | Low Downgraded: risk of bias, imprecision |
Improvement in androgenic symptoms at 6 months (hirsutism/acne) ‐ LOD vs gonadotrophins N of participants: 50 (1 RCT) LOD vs medical interventions | OR 3.2 [0.33, 30.94] | NR | Very low Downgraded: risk of bias, imprecision |
Harms: GI Upset at 6 months ‐ LOD vs metformin + clomiphene N of participants: 332 (2 RCTs) Harms: OHSS rates at 6 months ‐ LOD vs gonadotrophins N of participants: 33 (1 RCT) LOD vs medical interventions | OR 0.05 [0.01, 0.36] | NR | Moderate Downgraded: risk of bias |
LOD compared to other surgical interventions for symptom relief in women with polycystic ovary syndrome
Population: Women with symptoms of PCOS
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual regularity ‐ LOD vs unilateral LOD N of participants: 104 (2 RCTs) LOD vs other surgical interventions | OR 1.51 [0.62, 3.71] | NR | Moderate Downgraded: risk of bias |
Menstrual regularity at 6 months ‐ LOD vs ultrasound‐guided transvaginal ovarian drilling N of participants: 147 (1 RCT) LOD vs other surgical interventions | OR 1.23 [0.64, 2.37] | NR | Low Downgraded: risk of bias, imprecision |
Menstrual regularity at 12 months Laser LOD vs harmonic scalpel N of participants: 34 (1 RCT) LOD vs other surgical interventions | OR 2.13 [0.17, 26.03] | NR | Low Downgraded: risk of bias, imprecision |
Improvement in androgenic symptoms at 6 months (Acne) ‐ LOD vs USS guided N of participants:31 (1 RCT) LOD vs other surgical interventions | OR 0.84 [0.2, 3.5] | NR | Low Downgraded: risk of bias, imprecision |
Improvement in androgenic symptoms at 6 months (Hirsutism) ‐ LOD vs USS‐guided N of participants: 39 (1 RCT) LOD vs other surgical interventions | OR 1.09 [0.3, 3.91] | NR | Low Downgraded: risk of bias, imprecision |
Harms: Adhesions at 6 months ‐ LOD vs THL N of participants: 246 (1 RCT) LOD vs other surgical interventions | OR 0.1 [0.05, 0.18] | NR | Very low Downgraded: risk of bias, imprecision |
LOD 4‐5 compared to 2 or fewer punctures for symptom relief in women with polycystic ovary syndrome
Population: Women with symptoms of PCOS
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual regularity at 6 months ‐ LOD 4 ‐ 5 coagulation points compared to 2 or fewer N of participants: 73 (2 RCTs) LOD 4‐5 vs 2 or fewer punctures | OR 16.04 [4.19, 61.34] | NR | Low Downgraded: risk of bias, imprecision |
Menstrual regularity at 6 months ‐ LOD (4 ‐ 5 laser coagulation points) vs 1 laser coagulation point per ovary N of participants: 40 (1 RCT) LOD 4‐5 vs 2 or fewer punctures | OR 19 [2.12, 170.38] | NR | Low Downgraded: risk of bias, imprecision |
Menstrual regularity at 6 months ‐ LOD 4 punctures vs 2 punctures per ovary N of participants: 33 (1 RCT) LOD 4‐5 vs 2 or fewer punctures | OR 14 [2.6, 75.41] | NR | Low Downgraded: risk of bias, imprecision |
Improvement in androgenic symptoms LOD 4‐5 vs 2 or fewer punctures | no estimate extracted | NR | No studies |
Harms LOD 4 ‐ 5 versus fewer punctures LOD 4‐5 vs 2 or fewer punctures | no estimate extracted | NR | No studies |
LOD compared to LOD variable energy for symptom relief in women with polycystic ovary syndrome
Population: Women with symptoms of PCOS
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Menstrual regularity at 6 months ‐ LOD vs adjusted thermal dose N of participants: 115 (1 RCT) LOD vs LOD variable energy | OR 0.42 [0.16, 1.14] | NR | Very low Downgraded: risk of bias, imprecision |
Menstrual regularity at 3 months ‐ LOD unipolar vs LOD bipolar N of participants: 20 (1 RCT) LOD vs LOD variable energy | OR 1 [0.05, 18.57] | NR | Very low Downgraded: risk of bias, imprecision |
Improvement in androgenic symptoms LOD vs LOD variable energy | no estimate extracted | NR | No studies |
Harms: Adhesions at 6 months № of participants: 64 (1 study) LOD vs LOD variable energy | OR 0.96 [0.32, 2.88] | NR | Very low Downgraded: risk of bias, imprecision |