Cochrane Review Group

Gynaecology and Fertility

194 systematic reviews in Gynaecology and Fertility ask 2,653 questions. 20% have no studies to answer them, 31.1% rest on very low certainty evidence and 13.8% reach moderate or high certainty.

Reviews

194

Questions

2,653

current versions

No studies

20%

Moderate or high

13.8%

No studies 531 · 20%Ungraded 76 · 2.9%Very low 826 · 31.1%Low 855 · 32.2%Moderate 341 · 12.9%High 24 · 0.9%

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.

Search questions in Gynaecology and Fertility

Thinnest evidence

All no studies and very low questions

Question	Effect	Evidence	Status / GRADE
Transvaginal biological graft vs native tissue repair Bladder function · vaginal prolapse Transvaginal mesh or grafts or native tissue repair for vaginal prolapse (2024) · Cochrane	RR 12.64 [1.6, 100.06]	2 studies · 143 participants	Very low
Transvaginal biological graft vs native tissue repair Quality of life · vaginal prolapse Transvaginal mesh or grafts or native tissue repair for vaginal prolapse (2024) · Cochrane	no estimate extracted	3 studies · 112 participants	Very low
Transvaginal permanent mesh vs native tissue repair Recurrent prolapse on examination (any compartment) · vaginal prolapse Transvaginal mesh or grafts or native tissue repair for vaginal prolapse (2024) · Cochrane	RR 0.42 [0.32, 0.55]	25 studies · 3680 participants	Very low
Transvaginal permanent mesh vs native tissue repair Quality of life · vaginal prolapse Transvaginal mesh or grafts or native tissue repair for vaginal prolapse (2024) · Cochrane	no estimate extracted	9 studies · 1365 participants	Very low
Summary of findings table ‐ Metformin vs megestrol Regression of endometrial hyperplasia (with or without atypia) to proliferative, secretory, or atrophic endometrium · endometrial hyperplasia Metformin for endometrial hyperplasia (2024) · Cochrane	OR 4.89 [1.56, 15.32]	2 studies · 83 participants	Very low
Summary of findings table ‐ Metformin + megestrol vs megestrol Progression of endometrial hyperplasia to endometrial cancer · endometrial hyerplasia Metformin for endometrial hyperplasia (2024) · Cochrane	OR 7.96 [0.16, 402.02]	3 studies · 156 participants	Very low
Summary of findings table ‐ Metformin + megestrol vs megestrol Hysterectomy rate · endometrial hyerplasia Metformin for endometrial hyperplasia (2024) · Cochrane	OR 7.39 [0.15, 372.38]	2 studies · 72 participants	Very low
Summary of findings table ‐ Metformin + megestrol vs megestrol Abnormal uterine bleeding ‐ not measured · endometrial hyerplasia Metformin for endometrial hyperplasia (2024) · Cochrane	no estimate extracted	NR	No studies
Summary of findings table ‐ Metformin + megestrol vs megestrol Health‐related quality of life (HRQoL) ‐ not measured · endometrial hyerplasia Metformin for endometrial hyperplasia (2024) · Cochrane	no estimate extracted	NR	No studies
Summary of findings table ‐ Metformin + megestrol vs megestrol Adverse effects during treatment · endometrial hyerplasia Metformin for endometrial hyperplasia (2024) · Cochrane	no estimate extracted	1 study · 8 participants	Very low
Summary of findings table ‐ Metformin + levonorgestrel (intrauterine system) vs levonorgestrel intrauterine system Regression of endometrial hyperplasia (with or without atypia) to proliferative, secretory, or atrophic endometrium · endometrial hyperplasia Metformin for endometrial hyperplasia (2024) · Cochrane	OR 3.42 [0.13, 88.4]	1 study · 46 participants	Very low
Summary of findings table ‐ Metformin + levonorgestrel (intrauterine system) vs levonorgestrel intrauterine system Recurrence of endometrial hyperplasia ‐ not reported · endometrial hyperplasia Metformin for endometrial hyperplasia (2024) · Cochrane	no estimate extracted	NR	No studies

Reviews 194

Progestogen‐releasing intrauterine systems for heavy menstrual bleeding

Bofill Rodriguez, M, Lethaby, A, et al. · Cochrane Database of Systematic Reviews · 2020

Gynaecology and Fertility

Thinnest evidence

Reviews 194

Progestogen‐releasing intrauterine systems for heavy menstrual bleeding

Number of embryos for transfer following in vitro fertilisation or intra‐cytoplasmic sperm injection

Pre‐ and postsurgical medical therapy for endometriosis surgery

Tubal flushing for subfertility

Surgical treatment of fibroids for subfertility

Preimplantation genetic testing for aneuploidies (abnormal number of chromosomes) in in vitro fertilisation

Metformin versus the combined oral contraceptive pill for hirsutism, acne, and menstrual pattern in polycystic ovary syndrome

Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome

Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen

Hyaluronic acid in embryo transfer media for assisted reproductive technologies

Antioxidants for female subfertility

Progestogens or progestogen‐releasing intrauterine systems for uterine fibroids (other than preoperative medical therapy)

Regular (ICSI) versus ultra‐high magnification (IMSI) sperm selection for assisted reproduction

Laparoscopic surgery for endometriosis

Interventions for non‐tubal ectopic pregnancy

Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia

Endometrial injection of embryo culture supernatant for subfertile women in assisted reproduction

Granulocyte‐colony stimulating factor administration for subfertile women undergoing assisted reproduction

In‐bag manual versus uncontained power morcellation for laparoscopic myomectomy

GM‐CSF (granulocyte macrophage colony‐stimulating factor) supplementation in culture media for women undergoing assisted reproduction

Combined hormonal contraceptives for heavy menstrual bleeding

Non‐steroidal anti‐inflammatory drugs for heavy menstrual bleeding

Cyclical progestogens for heavy menstrual bleeding

Endometrial resection and ablation techniques for heavy menstrual bleeding