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Study flow diagram.
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Figure 1

Study flow diagram.

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'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Dopamine agonists alone versus no treatment, Outcome 1 Miscarriages.
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Analysis 1.1

Comparison 1 Dopamine agonists alone versus no treatment, Outcome 1 Miscarriages.

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Comparison 1 Dopamine agonists alone versus no treatment, Outcome 2 Live births.
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Analysis 1.2

Comparison 1 Dopamine agonists alone versus no treatment, Outcome 2 Live births.

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Comparison 1 Dopamine agonists alone versus no treatment, Outcome 3 Conception.
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Analysis 1.3

Comparison 1 Dopamine agonists alone versus no treatment, Outcome 3 Conception.

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Summary of findings for the main comparison. Bromocriptine versus no treatment for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history

Bromocriptine treatment versus no treatment for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history

Patient or population: women with idiopathic hyperprolactinemia and recurrent miscarriage history
Settings: recurrent spontaneous abortion clinic, Yokohama City University Hospital, Japan
Intervention: dopamine agonists (bromocriptine) alone

Comparison: no treatment

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with placebo/no treatment

Risk with Dopamine agonists alone

Miscarriages

Study population

RR 0.28
(0.09 to 0.87)

46
(1 study)

⊕⊕⊝⊝
low1,2

455 per 1000

127 per 1000
(41 to 395)

Moderate

455 per 1000

127 per 1000
(41 to 396)

Live births

Study population

RR 1.50
(0.93 to 2.42)

46
(1 study)

⊕⊝⊝⊝
very low1,3,4

500 per 1000

750 per 1000
(465 to 1000)

Moderate

500 per 1000

750 per 1000
(465 to 1000)

Conception

Study population

RR 0.92
(0.77 to 1.09)

46
(1 study)

⊕⊝⊝⊝
very low1,3,4

955 per 1000

878 per 1000
(735 to 1000)

Moderate

955 per 1000

878 per 1000
(735 to 1000)

Proportion reduction in serum prolactin levels

Study population

Not estimable

0
(0)

See comment

No data in included study

See comment

See comment

Moderate

Serum prolactin normalization

Study population

Not estimable

0
(0)

See comment

No data in included study

See comment

See comment

Moderate

Adverse maternal effects

Study population

Not estimable

0
(0)

See comment

No data in included study

See comment

See comment

Moderate

Adverse fetal outcomes

Study population

Not estimable

0
(0)

See comment

No data in included study

See comment

See comment

Moderate

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio.

GRADE Working Group grades of evidence

High quality: we are very confident that the true effect lies close to that of the estimate of the effect

Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different

Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect

Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 One trial with design limitations, including no description of allocation concealment, lack of blinding and possible outcome reporting bias (‐1).
2 Estimate based on small sample size and few events (‐1).
3 Estimate based on small sample size (‐1).
4 95% CI overlap with non‐significant line with small sample size (‐1).

Figures and Tables -
Summary of findings for the main comparison. Bromocriptine versus no treatment for preventing future miscarriage in women with idiopathic hyperprolactinemia and recurrent miscarriage history
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Comparison 1. Dopamine agonists alone versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Miscarriages Show forest plot

1

46

Risk Ratio (M‐H, Fixed, 95% CI)

0.28 [0.09, 0.87]

2 Live births Show forest plot

1

46

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.93, 2.42]

3 Conception Show forest plot

1

46

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.77, 1.09]
Figures and Tables -
Comparison 1. Dopamine agonists alone versus no treatment
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