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

Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities

Bosteels, J, van Wessel, S, et al. · Cochrane Database of Systematic Reviews · 2018

Gynaecology and Fertility

Thinnest evidence

Reviews 194

Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities

Vasodilators for women undergoing fertility treatment

Intrauterine administration of human chorionic gonadotropin (hCG) for subfertile women undergoing assisted reproduction

Application of seminal plasma to female genital tract prior to embryo transfer in assisted reproductive technology cycles (IVF, ICSI and frozen embryo transfer)

Metabolomics for improving pregnancy outcomes in women undergoing assisted reproductive technologies

Inositol for subfertile women with polycystic ovary syndrome

Surgery for women with posterior compartment prolapse

Perioperative interventions in pelvic organ prolapse surgery

Surgery for women with pelvic organ prolapse with or without stress urinary incontinence

Preoperative medical therapy before surgery for uterine fibroids

Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome

Insulin‐sensitising drugs (metformin, rosiglitazone, pioglitazone, D‐chiro‐inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility

Cycle regimens for frozen‐thawed embryo transfer

Long‐term hormone therapy for perimenopausal and postmenopausal women

Antibiotic prophylaxis for elective hysterectomy

Glucocorticoid supplementation during ovarian stimulation for IVF or ICSI

Nonsteroidal anti‐inflammatory drugs for pain in women with endometriosis

Recombinant luteinizing hormone (rLH) and recombinant follicle stimulating hormone (rFSH) for ovarian stimulation in IVF/ICSI cycles

Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Pain relief for outpatient hysteroscopy

Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation

Metformin during ovulation induction with gonadotrophins followed by timed intercourse or intrauterine insemination for subfertility associated with polycystic ovary syndrome

Ovarian surgery for symptom relief in women with polycystic ovary syndrome

Progesterone receptor modulators for endometriosis

Non‐contraceptive oestrogen‐containing preparations for controlling symptoms of premenstrual syndrome