Cochrane · systematic review · CD010287
Aromatase inhibitors (letrozole) for ovulation induction in infertile women with polycystic ovary syndrome
Franik, S, Le, Q-K, Kremer, JAM, et al. · Cochrane Database of Systematic Reviews · 2022 · 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
10
current version
GRADE rated
9
No studies
1
Included studies
NR
No studies 1 · 10%Ungraded 0 · 0%Very low 2 · 20%Low 2 · 20%Moderate 0 · 0%High 5 · 50%
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 onlyLetrozole with or without adjuncts compared to SERMs with or without adjuncts followed by timed intercourse for infertile women with polycystic ovary syndrome
Population: infertile women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Letrozole with or without adjuncts vs SERMs with or without adjuncts followed by timed intercourse | OR 1.72 [1.4, 2.11] | 11 studies · 2060 participants | High |
Ovarian hyperstimulation syndrome rate Letrozole with or without adjuncts vs SERMs with or without adjuncts followed by timed intercourse | no estimate extracted | 10 studies · 1848 participants | High |
Clinical pregnancy rate Letrozole with or without adjuncts vs SERMs with or without adjuncts followed by timed intercourse | OR 1.69 [1.45, 1.98] | 23 studies · 3321 participants | High |
Miscarriage rate per pregnancy Letrozole with or without adjuncts vs SERMs with or without adjuncts followed by timed intercourse | OR 0.94 [0.66, 1.32] | 15 studies · 736 participants | High |
Multiple pregnancy rate Letrozole with or without adjuncts vs SERMs with or without adjuncts followed by timed intercourse | OR 0.74 [0.42, 1.32] | 14 studies · 2247 participants | High |
Letrozole compared to laparoscopic ovarian drilling for infertile women with polycystic ovary syndrome
Population: infertile women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Letrozole vs laparoscopic ovarian drilling | OR 2.07 [0.99, 4.32] | 1 study · 141 participants | Very low Downgraded: risk of bias, imprecision |
Ovarian hyperstimulation syndrome rate Letrozole vs laparoscopic ovarian drilling | no estimate extracted | NR | No studies |
Clinical pregnancy rate Letrozole vs laparoscopic ovarian drilling | OR 1.47 [0.95, 2.28] | 3 studies · 376 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate per pregnancy Letrozole vs laparoscopic ovarian drilling | OR 0.65 [0.22, 1.92] | 3 studies · 122 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate Letrozole vs laparoscopic ovarian drilling | OR 3 [0.12, 74.9] | 1 study · 141 participants | Very low Downgraded: risk of bias, imprecision |
Letrozole with or without adjuncts compared to clomiphene citrate (CC) with or without adjuncts for subfertile women with polycystic ovary syndrome
Population: subfertile women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Letrozole with or without adjuncts vs clomiphene citrate (CC) with or without adjuncts | OR 1.68 [1.42, 1.99] | 13 studies · 2954 participants | Moderate Downgraded: risk of bias |
Ovarian hyperstimulation syndrome rate Letrozole with or without adjuncts vs clomiphene citrate (CC) with or without adjuncts | RD 0 | 12 studies · 2536 participants | High |
Clinical pregnancy rate Letrozole with or without adjuncts vs clomiphene citrate (CC) with or without adjuncts | OR 1.56 [1.37, 1.78] | 25 studies · 4629 participants | Moderate Downgraded: publication bias |
Miscarriage rate by pregnancies Letrozole with or without adjuncts vs clomiphene citrate (CC) with or without adjuncts | OR 0.94 [0.7, 1.26] | 18 studies · 1210 participants | High |
Multiple pregnancy rate Letrozole with or without adjuncts vs clomiphene citrate (CC) with or without adjuncts | OR 0.69 [0.41, 1.16] | 17 studies · 3579 participants | High |
Letrozole compared to laparoscopic ovarian drilling for subfertile women with polycystic ovary syndrome
Population: Subfertile women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Letrozole vs laparoscopic ovarian drilling | OR 1.38 [0.95, 2.02] | 3 studies · 548 participants | Low Downgraded: risk of bias, imprecision |
Ovarian hyperstimulation syndrome rate Letrozole vs laparoscopic ovarian drilling | RD 0 | 1 study · 260 participants | Low Downgraded: imprecision |
Clinical pregnancy rate Letrozole vs laparoscopic ovarian drilling | OR 1.28 [0.94, 1.74] | 5 studies · 774 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate by pregnancies Letrozole vs laparoscopic ovarian drilling | OR 0.66 [0.3, 1.43] | 5 studies · 240 participants | Moderate Downgraded: risk of bias |
Multiple pregnancy rate Letrozole vs laparoscopic ovarian drilling | OR 3 [0.12, 74.9] | 3 studies · 548 participants | Low Downgraded: risk of bias, imprecision |
Aromatase inhibitors compared to clomiphene citrate with or without adjuncts for subfertile women with polycystic ovary syndrome
Population: Subfertile women with polycystic ovary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Aromatase inhibitors vs clomiphene citrate with or without adjuncts | OR 1.64 [1.32, 2.04] | 9 studies · 1783 participants | Low |
Ovarian hyperstimulation syndrome rate Aromatase inhibitors vs clomiphene citrate with or without adjuncts | no estimate extracted | 9 studies · 2179 participants | Moderate |
Clinical pregnancy rate Aromatase inhibitors vs clomiphene citrate with or without adjuncts | OR 1.4 [1.18, 1.65] | 15 studies · 2816 participants | Low Downgraded: publication bias |
Miscarriage rate per woman randomised Aromatase inhibitors vs clomiphene citrate with or without adjuncts | OR 1.32 [0.92, 1.88] | 12 studies · 2385 participants | Moderate |
Miscarriage rate per pregnancy Aromatase inhibitors vs clomiphene citrate with or without adjuncts | OR 0.91 [0.61, 1.36] | 12 studies · 696 participants | Moderate |
Multiple pregnancy rate Aromatase inhibitors vs clomiphene citrate with or without adjuncts | OR 0.38 [0.17, 0.84] | 11 studies · 2385 participants | Moderate |