Trial reportObstetrics and gynecology2012
Endometrial shedding effect on conception and live birth in women with polycystic ovary syndrome.
Trial report in Obstetrics and gynecology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04175990 (Role Of Dydrogesterone Towards Oocyte and Embryo Quality in Polycystic Ovarian Syndrome), which is not on this map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Role Of Dydrogesterone Towards Oocyte and Embryo Quality in Polycystic Ovarian Syndrome (PCOS)
Who cites it
13 citing papers in PubMed, 55 citations in OpenAlex.
- Immediate versus delayed frozen embryo transfer in women following a failed IVF-ET attempt: a multicenter randomized controlled trial.Reproductive biology and endocrinology : RB&E · 2021 · on this mapTrial
- Effect of pretreatment with oral contraceptives and progestins on IVF outcomes in women with polycystic ovary syndrome.Human reproduction (Oxford, England) · 2017Trial
- Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS.The Journal of clinical endocrinology and metabolism · 2016Trial
- Trial
- Letrozole versus clomiphene for infertility in the polycystic ovary syndrome.The New England journal of medicine · 2014Trial
- A Novel Letrozole Stair-Step Duration Regimen for Ovulation Induction in Women with Polycystic Ovary Syndrome and Letrozole Resistance.Drug design, development and therapy · 2025Article
- Which transfer day results in the highest live birth rate for PCOS patients undergoing in vitro fertilization?BMC pregnancy and childbirth · 2023Article
- A Randomized Cohort Study: Is It Worth the Time to Receive Antiandrogenic Pretreatment Before Ovulation Induction for Women With Polycystic Ovary Syndrome?Frontiers in endocrinology · 2022Article
- A Comparison of the Efficacy of ImmediateFrontiers in endocrinology · 2021Article
- Ovulation Induction for the General Gynecologist.Journal of obstetrics and gynaecology of India · 2018Review
- Optimal management of subfertility in polycystic ovary syndrome.International journal of women's health · 2014Review
- Does progesterone-induced endometrial withdrawal bleed before ovulation induction have negative effects on IUI outcomes in patients with polycystic ovary syndrome?International journal of clinical and experimental pathology · 2013Article
- The stair-step approach in treatment of anovulatory PCOS patients.Therapeutic advances in reproductive healthReview
Corrections and comments
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Authors and funding
20 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveTo estimate whether progestin-induced endometrial shedding, before ovulation induction with clomiphene citrate, metformin, or a combination of both, affects ovulation, conception, and live birth rates in women with polycystic ovary syndrome (PCOS).
methodsA secondary analysis of the data from 626 women with PCOS from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Network trial was performed. Women had been randomized to up to six cycles of clomiphene citrate alone, metformin alone, or clomiphene citrate plus metformin. Women were assessed for occurrence of ovulation, conception, and live birth in relation to prior bleeding episodes (after either ovulation or exogenous progestin-induced withdrawal bleed).
resultsAlthough ovulation rates were higher in cycles preceded by spontaneous endometrial shedding than after anovulatory cycles (with or without prior progestin withdrawal), both conception and live birth rates were significantly higher after anovulatory cycles without progestin-induced withdrawal bleeding (live births per cycle: spontaneous menses 2.2%; anovulatory with progestin withdrawal 1.6%; anovulatory without progestin withdrawal 5.3%; P<.001). The difference was more marked when rate was calculated per ovulation (live births per ovulation: spontaneous menses 3.0%; anovulatory with progestin withdrawal 5.4%; anovulatory without progestin withdrawal 19.7%; P<.001).
conclusionConception and live birth rates are lower in women with PCOS after a spontaneous menses or progestin-induced withdrawal bleeding as compared with anovulatory cycles without progestin withdrawal. The common clinical practice of inducing endometrial shedding with progestin before ovarian stimulation may have an adverse effect on rates of conception and live birth in anovulatory women with PCOS. LEVEL OF EVIDENCE: II.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.