Evidence map›Paper›PMID 38280115›Full record

SynthesisHormones (Athens, Greece)2024

Effects of letrozole alone or in combination with gonadotropins on ovulation induction and clinical pregnancy in women with polycystic ovarian syndrome: a systematic review and meta-analysis of randomized controlled trials.

Saeed Baradwan, Faisal Al-Shalhoub, Majed Saeed Alshahrani, Samah Himayda, Rayan AlSghan, Hussein Sabban, Inass Hassan Ahmad, Marwa Fekry Mohamed El Sayed, Entesar Omar Mohamad, Abdulhadi A AlAmodi and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Hormones (Athens, Greece), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 3 countries.

Saeed BaradwanDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Faisal Al-ShalhoubDepartment of Obstetrics and Gynecology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Majed Saeed AlshahraniDepartment of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia.
Samah HimaydaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Rayan AlSghanDepartment of Obstetrics and Gynecology, Maternity and Children Hospital, Al-Kharj, Saudi Arabia.
Hussein SabbanDepartment of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Inass Hassan AhmadDepartment of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Marwa Fekry Mohamed El SayedDepartment of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Entesar Omar MohamadDepartment of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Abdulhadi A AlAmodiCollege of Health Sciences and Public Health, Jackson State University, Jackson, MS, USA.
Ahmed Mohamed AbdelhakimKasralainy Faculty of Medicine, Cairo University, 395 Portsaid Street, Bab El-Kalq, Cairo, 11638, Egypt. ahmed.m.rohei@students.kasralainy.edu.eg.ORCID http://orcid.org/0000-0001-9579-8366
Kareem ShaheenDepartment of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.
Al-Azhar University · EGCairo University · EGJackson State University · USKing Abdulaziz University · SAKing Fahd Armed Forces Hospital · SAKing Faisal Specialist Hospital & Research Centre · SAMaternity and Children's Hospital · SAMinia University · EGNajran University · SAUmm al-Qura University · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare letrozole in combination with gonadotropins versus letrozole monotherapy in ovulation induction and clinical pregnancy among infertile women with polycystic ovarian syndrome (PCOS).

methodsSeveral databases were searched for available clinical trials from inception until March 2023. We selected randomized controlled trials (RCTs) that compared sequential letrozole/gonadotropin versus letrozole alone among infertile women who met the Rotterdam criteria for PCOS. RevMan software was used to perform our meta-analysis. Our primary outcomes were ovulation and clinical pregnancy rates. Our secondary outcomes were endometrial thickness, number of mature follicles (diameter ≥ 18 mm), and incidence of miscarriage and ovarian hyperstimulation syndrome (OHSS).

resultsSix RCTs were retrieved with a total number of 723 patients. The ovulation and clinical pregnancy rates were significantly higher among the letrozole/gonadotropin group versus the letrozole monotherapy group (p < 0.001). In addition, there were significant improvements in endometrial thickness and number of mature follicles in the letrozole/gonadotropin group. There were no significant differences between the two groups regarding incidence of miscarriage and ovarian hyperstimulation syndrome.

conclusionLetrozole in combination with gonadotropin is superior to letrozole alone in improving ovulation induction and clinical pregnancy among PCOS patients. More trials are required to confirm our findings.

Indexed as

GonadotropinsInfertility, FemaleLetrozoleOvulation InductionPolycystic Ovary SyndromeAromatase InhibitorsDrug Therapy, CombinationFemaleFertility Agents, FemaleHumansPregnancyPregnancy RateRandomized Controlled Trials as TopicAromatase InhibitorsFertility Agents, FemaleGonadotropinsLetrozoleGonadotropinsLetrozolePCOSPolycystic ovary syndromePregnancy rate

Identifiers

PMID38280115
OpenAlexW4391282236

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.