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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Forest plot of comparison: 1 Anti‐oestrogen versus no treatment/placebo, outcome: 1.1 Clomiphene versus placebo.
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Figure 3

Forest plot of comparison: 1 Anti‐oestrogen versus no treatment/placebo, outcome: 1.1 Clomiphene versus placebo.

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Forest plot of comparison: 2 Anti‐oestrogen versus anti‐oestrogen, outcome: 2.1 Clomiphene versus tamoxifen.
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Figure 4

Forest plot of comparison: 2 Anti‐oestrogen versus anti‐oestrogen, outcome: 2.1 Clomiphene versus tamoxifen.

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Forest plot of comparison: 2 Anti‐oestrogen versus anti‐oestrogen, outcome: 2.2 Clomiphene plus tamoxifen versus clomiphene.
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Figure 5

Forest plot of comparison: 2 Anti‐oestrogen versus anti‐oestrogen, outcome: 2.2 Clomiphene plus tamoxifen versus clomiphene.

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Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.2 Clomiphene plus bromocriptine versus clomiphene.
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Figure 6

Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.2 Clomiphene plus bromocriptine versus clomiphene.

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Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.3 Clomiphene plus dexamethasone versus clomiphene.
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Figure 7

Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.3 Clomiphene plus dexamethasone versus clomiphene.

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Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.4 Clomiphene plus combined oral contraceptive vs clomiphene.
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Figure 8

Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.4 Clomiphene plus combined oral contraceptive vs clomiphene.

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Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.5 Clomiphene plus hCG versus clomiphene alone.
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Figure 9

Forest plot of comparison: 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, outcome: 3.5 Clomiphene plus hCG versus clomiphene alone.

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Comparison 1 Anti‐oestrogen versus no treatment or placebo, Outcome 1 Clomiphene versus placebo.
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Analysis 1.1

Comparison 1 Anti‐oestrogen versus no treatment or placebo, Outcome 1 Clomiphene versus placebo.

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Comparison 2 Anti‐oestrogen versus anti‐oestrogen, Outcome 1 Clomiphene versus tamoxifen.
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Analysis 2.1

Comparison 2 Anti‐oestrogen versus anti‐oestrogen, Outcome 1 Clomiphene versus tamoxifen.

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Comparison 2 Anti‐oestrogen versus anti‐oestrogen, Outcome 2 Clomiphene plus tamoxifen versus clomiphene.
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Analysis 2.2

Comparison 2 Anti‐oestrogen versus anti‐oestrogen, Outcome 2 Clomiphene plus tamoxifen versus clomiphene.

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Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 1 Clomiphene plus ketoconazole versus clomiphene.
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Analysis 3.1

Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 1 Clomiphene plus ketoconazole versus clomiphene.

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Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 2 Clomiphene plus bromocriptine versus clomiphene.
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Analysis 3.2

Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 2 Clomiphene plus bromocriptine versus clomiphene.

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Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 3 Clomiphene plus dexamethasone versus clomiphene.
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Analysis 3.3

Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 3 Clomiphene plus dexamethasone versus clomiphene.

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Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 4 Clomiphene plus combined oral contraceptive vs clomiphene.
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Analysis 3.4

Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 4 Clomiphene plus combined oral contraceptive vs clomiphene.

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Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 5 Clomiphene plus hCG versus clomiphene alone.
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Analysis 3.5

Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 5 Clomiphene plus hCG versus clomiphene alone.

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Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 6 Clomiphene versus clomiphene plus hormone supplementation.
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Analysis 3.6

Comparison 3 Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone, Outcome 6 Clomiphene versus clomiphene plus hormone supplementation.

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Comparison 1. Anti‐oestrogen versus no treatment or placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clomiphene versus placebo Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Pregnancy rate (per woman)

3

133

Odds Ratio (M‐H, Fixed, 95% CI)

5.77 [1.55, 21.48]

1.2 Ovulation rate (per woman)

3

133

Odds Ratio (M‐H, Fixed, 95% CI)

7.47 [3.24, 17.23]
Figuras y tablas -
Comparison 1. Anti‐oestrogen versus no treatment or placebo
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Comparison 2. Anti‐oestrogen versus anti‐oestrogen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clomiphene versus tamoxifen Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Pregnancy rate (per woman)

2

190

Odds Ratio (M‐H, Fixed, 95% CI)

0.94 [0.46, 1.94]

1.2 Ovulation rate (per woman)

1

95

Odds Ratio (M‐H, Fixed, 95% CI)

1.49 [0.66, 3.40]

1.3 Miscarriage rate (per woman)

1

86

Odds Ratio (M‐H, Fixed, 95% CI)

0.37 [0.01, 9.45]

1.4 Live birth rate (per woman)

1

95

Odds Ratio (M‐H, Fixed, 95% CI)

0.33 [0.03, 3.25]

1.5 On‐going pregnancy rate (per woman)

1

95

Odds Ratio (M‐H, Fixed, 95% CI)

0.19 [0.02, 1.67]

2 Clomiphene plus tamoxifen versus clomiphene Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Pregnancy rate (per woman)

1

20

Odds Ratio (M‐H, Fixed, 95% CI)

3.32 [0.12, 91.60]

2.2 Ovulation rate (per woman)

1

20

Odds Ratio (M‐H, Fixed, 95% CI)

14.54 [0.67, 316.69]
Figuras y tablas -
Comparison 2. Anti‐oestrogen versus anti‐oestrogen
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Comparison 3. Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clomiphene plus ketoconazole versus clomiphene Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Pregnancy rate (per woman)

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

2.37 [0.88, 6.40]

1.2 Multiple pregnancy (per woman)

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.18 [0.37, 3.78]

1.3 Spontaneous abortion (after cord pulse)

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.28 [0.01, 7.08]

2 Clomiphene plus bromocriptine versus clomiphene Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Pregnancy rate (per woman)

1

100

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.33, 2.96]

2.2 Ovulation rate (per woman)

1

100

Odds Ratio (M‐H, Fixed, 95% CI)

1.33 [0.47, 3.79]

3 Clomiphene plus dexamethasone versus clomiphene Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Pregnancy rate (per woman)

3

374

Odds Ratio (M‐H, Fixed, 95% CI)

9.46 [5.05, 17.70]

3.2 Ovulation rate (per woman)

3

374

Odds Ratio (M‐H, Fixed, 95% CI)

14.65 [8.76, 24.49]

3.3 Multiple pregnancy (per woman)

2

144

Odds Ratio (M‐H, Fixed, 95% CI)

7.71 [0.38, 155.64]

4 Clomiphene plus combined oral contraceptive vs clomiphene Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Pregnancy rate (per woman)

1

48

Odds Ratio (M‐H, Fixed, 95% CI)

27.18 [3.14, 235.02]

4.2 Ovulation rate (per woman)

1

48

Odds Ratio (M‐H, Fixed, 95% CI)

26.71 [4.91, 145.38]

4.3 Miscarriage rate (per woman)

1

48

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.06, 16.97]

4.4 Multiple pregnancy (per woman)

1

48

Odds Ratio (M‐H, Fixed, 95% CI)

7.98 [0.39, 163.33]

5 Clomiphene plus hCG versus clomiphene alone Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Ovulation rate (per woman)

2

192

Odds Ratio (M‐H, Fixed, 95% CI)

3.48 [1.71, 7.06]

5.2 Pregnancy rate (per woman)

2

192

Odds Ratio (M‐H, Fixed, 95% CI)

1.18 [0.59, 2.36]

5.3 Clinical pregnancy rate (per woman)

1

125

Odds Ratio (M‐H, Fixed, 95% CI)

1.31 [0.61, 2.80]

5.4 Multiple pregnancies (per woman)

1

125

Odds Ratio (M‐H, Fixed, 95% CI)

2.21 [0.19, 24.98]

5.5 Spontaneous abortion/miscarriage

2

192

Odds Ratio (M‐H, Fixed, 95% CI)

0.70 [0.19, 2.62]

6 Clomiphene versus clomiphene plus hormone supplementation Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Ovulation rate (per woman)

1

65

Odds Ratio (M‐H, Fixed, 95% CI)

1.34 [0.42, 4.27]

6.2 Pregnancy rate (per woman)

1

65

Odds Ratio (M‐H, Fixed, 95% CI)

0.42 [0.07, 2.48]

6.3 Adverse events

1

65

Odds Ratio (M‐H, Fixed, 95% CI)

4.85 [0.22, 104.99]
Figuras y tablas -
Comparison 3. Anti‐oestrogen plus medical adjunct versus anti‐oestrogen alone
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