Table 2 Summary of finding table.

From: Conventional GnRH antagonist protocols versus long GnRH agonist protocol in IVF/ICSI cycles of polycystic ovary syndrome women: a systematic review and meta-analysis

Outcome

Anticipated absolute effects (95% CI)

Relative effect (95% CI)

№ of participants (studies)

Certainty

Risk with Long GnRH agonist

Risk with Conventional GnRH antagonist

Live birth rate

486 per 1,000

379 per 1,000 (224 to 642)

RR 0.78 (0.46 to 1.32)

74 (1 RCT)

⨁⨁◯◯ LOW a

Ongoing pregnancy rate

435 per 1,000

400 per 1,000 (339 to 470)

RR 0.92 (0.78 to 1.08)

785 (5 RCTs)

⨁⨁⨁⨁ HIGH

OHSS rate (All grades)

173 per 1,000

101 per 1,000 (76 to 134)

RR 0.58 (0.44 to 0.77)

994 (9 RCTs)

⨁⨁◯◯ LOW b,c

Mild OHSS rate

204 per 1,000

165 per 1,000 (98 to 279)

RR 0.81 (0.48 to 1.37)

229 (3 RCTs)

⨁◯◯◯ VERY LOW a,b

Moderate-Severe OHSS rate

196 per 1,000

127 per 1,000 (102 to 161)

RR 0.65 (0.52 to 0.82)

1114 (9 RCTs)

⨁◯◯◯ VERY LOW b,d

Clinical pregnancy rate

415 per 1,000

399 per 1,000 (320 to 494)

RR 0.96 (0.77 to 1.19)

840 (8 RCTs)

⨁⨁⨁⨁ HIGH

Multiple pregnancy rate

99 per 1,000

86 per 1,000 (58 to 125)

RR 0.87 (0.59 to 1.27)

994 (9 RCTs)

⨁◯◯◯ VERY LOW b,d

Miscarriage rate

86 per 1,000

80 per 1,000 (53 to 123)

RR 0.93 (0.61 to 1.43)

997 (7 RCTs)

⨁◯◯◯ VERY LOW a,b

Cycle cancellation rate

54 per 1,000

62 per 1,000 (37 to 103)

RR 1.15 (0.69 to 1.91)

1002 (8 RCTs)

⨁◯◯◯ VERY LOW a,b

Cycle cancellation rate due to high risk of OHSS

32 per 1,000

19 per 1,000 (8 to 43)

RR 0.59 (0.26 to 1.34)

869 (6 RCTs)

⨁◯◯◯ VERY LOW a,b

Cycle cancellation rate due to poor ovarian response

7 per 1,000

32 per 1,000 (10 to 99)

RR 4.63 (1.49 to 14.41)

869 (6 RCTs)

⨁◯◯◯ VERY LOW b,e

Duration of stimulation

The mean duration of stimulation ranged from 9.07–13.92 Days

MD 0.91 Days. Lower (1.45 lower to 0.37 lower)

–

1182 (10 RCTs)

⨁◯◯◯ VERY LOW f,g

Gonadotropin Dose

The mean gonadotropin Dose ranged from 2675.5–1370.16 IUs

MD 221.36 IUs. Lower (332.28 lower to 110.45 lower)

–

845 (7 RCTs)

⨁⨁⨁⨁ HIGH

E2 levels hCG day

The mean E2 levels day of hCG ranged from 2232.7–4424.43 pg/ml

MD 259.21 pg/ml. lower (485.81 lower to 32.6 lower)

–

995 (8 RCTs)

⨁⨁⨁◯ MODERATE g

Endometrial thickness on hCG day

The mean endometrial thickness on day of hCG ranged from 6.7–11.57 mm

MD 0.73 mm. lower (1.17 lower to 0.29 lower)

–

550 (5 RCTs)

⨁⨁⨁◯ MODERATE g

Number of retrieved oocytes

The mean no. of retrieved oocytes ranged from 13.71–26.07 oocytes

MD 1.82 oocytes. Lower (3.48 lower to 0.15 lower)

–

770 (8 RCTs)

⨁⨁◯◯ LOW g,h

  1. E2: Estradiol, GnRH: Gonadotropin-releasing hormone, hCG: Human chorionic gonadotropin, OHSS: ovarian hyperstimulation syndrome.
  2. aEvidence downgraded by two levels for very serious imprecision – 95% CI includes both appreciable benefit and harm or no effect and very low number of events (total number of events < 300).
  3. bEvidence downgraded by one level for serious risk of bias – the majority of the RCTs have some concern or high risk of bias.
  4. cEvidence downgraded by one level for serious imprecision – low number of events (total number of events < 300).
  5. dEvidence downgraded by two levels for very serious imprecision – 95% CI includes both appreciable effect and little or no effect and very low number of events (total number of events < 300).
  6. eEvidence downgraded by two levels for very serious imprecision—low number of events (total number of events < 300) and the effect estimate has a wide confidence interval.
  7. fEvidence downgraded by two levels for very serious inconsistency (unexplained heterogeneity).
  8. gEvidence downgraded by one level for serious imprecision – 95% CI includes both appreciable effect and little or no effect.
  9. hEvidence downgraded by one level for serious inconsistency (unexplained heterogeneity).
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