Aspiracija ciste jajnika prije in vitro oplodnje za liječenje smanjene plodnosti
Appendices
Appendix 1. MDSG search strategy
<Inception to 19 May 2014>
Keywords CONTAINS "ovarian cyst" or "Ovarian Cysts" or "ovarian cystectomy" or "cyst drainage" or "cyst puncture" or "cyst recurrence" or "cyst resolution" or "cystectomy" or "excision" or "Aspiration" or Title CONTAINS "ovarian cyst" or "Ovarian Cysts" or "ovarian cystectomy" or "cyst drainage" or "cyst puncture" or "cyst recurrence" or "cyst resolution" or "cystectomy" or "excision" or "Aspiration" AND Keywords CONTAINS "Pretreatment", "ivf" or "icsi" or "in‐vitro fertilisation " or "in vitro fertilization" or "intracytoplasmic sperm injection techniques" or "intracytoplasmic sperm injection cycle" or "intracytoplasmic sperm injection" or "Intracyst" or "*Ovulation Induction" or "ART" or "assisted reproduction" or "assisted reproduction techniques" or "COH" or "controlled ovarian hyperstimulation" or "controlled ovarian stimulation" or Title CONTAINS"Pretreatment", "ivf" or "icsi" or "in‐vitro fertilisation " or "in vitro fertilization" or "intracytoplasmic sperm injection techniques" or "intracytoplasmic sperm injection cycle" or "intracytoplasmic sperm injection" or "Intracyst" or "*Ovulation Induction" or "ART" or "assisted reproduction" or "assisted reproduction techniques" or "COH" or "controlled ovarian hyperstimulation" or "controlled ovarian stimulation"
Appendix 2. EBM Reviews ‐ Cochrane Central Register of Controlled Trials search strategy
Database: EBM Reviews ‐ Cochrane Central Register of Controlled Trials
<Inception ‐ 19 May 2014>
1 exp fertilization in vitro/ or exp sperm injections, intracytoplasmic/ (1447)
2 in vitro fertilization.tw. (1195)
3 in vitro fertilisation.tw. (119)
4 intracytoplasmic sperm injection$.tw. (403)
5 (ivf or icsi).tw. (2145)
6 ovulation induction.tw. (409)
7 ART.tw. (892)
8 assisted reproductive technolog$.tw. (111)
9 controlled ovarian hyperstimulation.tw. (246)
10 ovar$ stimulat$.tw. (679)
11 or/1‐10 (4275)
12 (cyst$ adj5 aspirat$).tw. (44)
13 (cyst$ adj5 remov$).tw. (44)
14 (cyst$ adj5 reduc$).tw. (193)
15 (cyst$ adj5 resect$).tw. (43)
16 (cyst$ adj5 excis$).tw. (21)
17 (ovar$ cyst adj5 surg$).tw. (2)
18 (cyst$ adj3 tumour$).tw. (30)
19 (cyst$ adj3 tumor$).tw. (38)
20 (corpus luteum adj5 cyst$).tw. (1)
21 cystectom$.tw. (255)
22 exp Cystectomy/ (127)
23 or/12‐22 (624)
24 11 and 23 (14)
Appendix 3. MEDLINE (R) In‐Process & Other Non‐Indexed Citations, Ovid MEDLINE (R) Daily and Ovid MEDLINE (R) search strategy
<Inception ‐ 19 May 2014>
1 exp fertilization in vitro/ or exp sperm injections, intracytoplasmic/ (25320)
2 in vitro fertilization.tw. (13890)
3 in vitro fertilisation.tw. (1173)
4 intracytoplasmic sperm injection$.tw. (4294)
5 (ivf or icsi).tw. (16395)
6 ovulation induction.tw. (2630)
7 ART.tw. (37082)
8 assisted reproductive technolog$.tw. (3048)
9 controlled ovarian hyperstimulation.tw. (1132)
10 ovar$ stimulat$.tw. (3445)
11 or/1‐10 (72339)
12 (cyst$ adj5 aspirat$).tw. (2021)
13 (cyst$ adj5 remov$).tw. (3407)
14 (cyst$ adj5 reduc$).tw. (4709)
15 (cyst$ adj5 resect$).tw. (3017)
16 (cyst$ adj5 excis$).tw. (2873)
17 (ovar$ cyst adj5 surg$).tw. (66)
18 (cyst$ adj3 tumour$).tw. (1375)
19 (cyst$ adj3 tumor$).tw. (6119)
20 (corpus luteum adj5 cyst$).tw. (188)
21 cystectom$.tw. (8405)
22 exp Cystectomy/ (4619)
23 or/12‐22 (30483)
24 randomized controlled trial.pt. (321955)
25 controlled clinical trial.pt. (83688)
26 randomized.ab. (237538)
27 placebo.tw. (137505)
28 clinical trials as topic.sh. (158334)
29 randomly.ab. (174662)
30 trial.ti. (101611)
31 (crossover or cross‐over or cross over).tw. (52521)
32 or/24‐31 (788443)
33 exp animals/ not humans.sh. (3681302)
34 32 not 33 (727668)
35 11 and 23 and 34 (15)
Appendix 4. EMBASE search strategy
<Inception ‐ 19 May 2014>
1 exp fertilization in vitro/ (36636)
2 exp intracytoplasmic sperm injection/ (11191)
3 in vitro fertilization.tw. (17635)
4 in vitro fertilisation.tw. (1780)
5 intracytoplasmic sperm injection$.tw. (5788)
6 (ivf or icsi).tw. (25712)
7 ovulation induction.tw. (3640)
8 ART.tw. (53680)
9 assisted reproductive technolog$.tw. (4693)
10 controlled ovarian hyperstimulation.tw. (1678)
11 ovar$ stimulat$.tw. (5351)
12 or/1‐11 (105538)
13 (cyst$ adj5 aspirat$).tw. (2570)
14 (cyst$ adj5 remov$).tw. (4378)
15 (cyst$ adj5 reduc$).tw. (5654)
16 (cyst$ adj5 resect$).tw. (4092)
17 (cyst$ adj5 excis$).tw. (3667)
18 (ovar$ cyst adj5 surg$).tw. (104)
19 (cyst$ adj3 tumour$).tw. (1748)
20 (cyst$ adj3 tumor$).tw. (7798)
21 (corpus luteum adj5 cyst$).tw. (213)
22 cystectom$.tw. (12229)
23 exp CYSTECTOMY/ (13816)
24 or/13‐23 (42988)
25 12 and 24 (337)
26 Clinical Trial/ (876945)
27 Randomized Controlled Trial/ (340667)
28 exp randomization/ (61219)
29 Single Blind Procedure/ (17264)
30 Double Blind Procedure/ (114133)
31 Crossover Procedure/ (36683)
32 Placebo/ (216470)
33 Randomi?ed controlled trial$.tw. (85761)
34 Rct.tw. (11270)
35 random allocation.tw. (1229)
36 randomly allocated.tw. (18579)
37 allocated randomly.tw. (1876)
38 (allocated adj2 random).tw. (717)
39 Single blind$.tw. (13192)
40 Double blind$.tw. (135581)
41 ((treble or triple) adj blind$).tw. (310)
42 placebo$.tw. (187354)
43 prospective study/ (230661)
44 or/26‐43 (1321345)
45 case study/ (19314)
46 case report.tw. (242133)
47 abstract report/ or letter/ (865150)
48 or/45‐47 (1121555)
49 44 not 48 (1285138)
50 25 and 49 (40)
51 (2012$ or 2013$).em. (1665341)
52 50 and 51 (4)
Appendix 5. PsycINFO (Ovid) search strategy
<Inception ‐ 19 May 2014>
1 exp Reproductive Technology/ (1129)
2 in vitro fertilization.tw. (418)
3 in vitro fertilisation.tw. (57)
4 intracytoplasmic sperm injection$.tw. (31)
5 (ivf or icsi).tw. (326)
6 ovulation induction.tw. (10)
7 ART.tw. (26443)
8 controlled ovarian hyperstimulation.tw. (1)
9 ovar$ stimulat$.tw. (16)
10 assisted reproductive techn$.tw. (242)
11 or/1‐10 (27693)
12 (cyst$ adj5 aspirat$).tw. (3)
13 (cyst$ adj5 remov$).tw. (47)
14 (cyst$ adj5 reduc$).tw. (71)
15 (cyst$ adj5 resect$).tw. (9)
16 (cyst$ adj5 excis$).tw. (10)
17 (ovar$ cyst adj5 surg$).tw. (0)
18 (cyst$ adj3 tumour$).tw. (4)
19 (cyst$ adj3 tumor$).tw. (27)
20 (corpus luteum adj5 cyst$).tw. (0)
21 cystectom$.tw. (13)
22 or/12‐21 (176)
23 11 and 22 (2)
Appendix 6. CINAHL (EBSCO) search strategy
<Inception ‐ 19 May 2014>
| # | Query | Results |
| S15 | S8 and S14 | 36 |
| S14 | S9 or S10 or S11 or S12 or S13 | 7,722 |
| S13 | TX cyst* drain* | 74 |
| S12 | TX cyst* excis* | 211 |
| S11 | (MH "Aspiration") OR TX aspiration | 6,746 |
| S10 | TX cyst* aspirat* | 143 |
| S9 | (MH "Cystectomy") OR TX "cystectomy" | 715 |
| S8 | S1 or S2 or S3 or S4 or S5 or S6 or S7 | 5,338 |
| S7 | TX assisted reproductive technolog* | 600 |
| S6 | (MM "Embryo Transfer") | 200 |
| S5 | (MH "Reproduction Techniques+") | 4,907 |
| S4 | (MH "Ovulation Induction") OR TX "ovulation induction" | 430 |
| S3 | TX icsi | 214 |
| S2 | TX "intracytoplasmic sperm injection" | 209 |
| S1 | TX ivf OR (MM "Fertilization in Vitro") | 1,707 |
Appendix 7. PubMed
<Inception to 19 May 2014>
Keywords included:
(("ovarian cysts"[MeSH Terms] OR ("ovarian"[All Fields] AND "cysts"[All Fields]) OR "ovarian cysts"[All Fields] OR ("ovarian"[All Fields] AND "cyst"[All Fields]) OR "ovarian cyst"[All Fields]) AND ("J In Vitro Fert Embryo Transf"[Journal] OR "ivf"[All Fields])) OR (("sperm injections, intracytoplasmic"[MeSH Terms] OR ("sperm"[All Fields] AND "injections"[All Fields] AND "intracytoplasmic"[All Fields]) OR "intracytoplasmic sperm injections"[All Fields] OR "icsi"[All Fields]) AND aspiration[All Fields]) (13)
Appendix 8. Clinicaltrials.gov and WHO portal for ongoing trials search strategy
<Inception ‐ 24 April 2013>
Keywords included:
Ovarian cyst and IVF (36) ‐ Clinicaltrials.gov
Ovarian cyst and IVF (38) ‐ WHO
Appendix 9. Google Scholar search strategy
<inception ‐ 14 August 2014
Keywords included:
"ovarian cyst*" AND aspiration AND (IVF OR "controlled ovarian hyperstimulation")
Appendix 10. PubMed clinical trials
<inception ‐ 14 August 2014
Keywords included:
(("ovarian cyst"[All Fields] OR "ovarian cysts"[All Fields]) AND aspiration[All Fields]) AND (("J In Vitro Fert Embryo Transf"[Journal] OR "ivf"[All Fields]) OR "controlled ovarian hyperstimulation"[All Fields])
Study flow diagram.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Forest plot of comparison: 1 Cyst aspiration versus conservative management, outcome: 1.1 NEW Clinical Pregnancy Rate.
Forest plot of comparison: 1 Cyst aspiration versus conservative management, outcome: 1.2 Number of Follicles Recruited.
Comparison 1 Cyst aspiration versus conservative management, Outcome 1 Clinical Pregnancy Rate.
Comparison 1 Cyst aspiration versus conservative management, Outcome 2 Number of Follicles Recruited.
Comparison 1 Cyst aspiration versus conservative management, Outcome 3 Number of Oocytes Collected.
Comparison 1 Cyst aspiration versus conservative management, Outcome 4 Cancellation rate.
| Cyst aspiration versus conservative management for subfertility | ||||||
| Population: women with subfertility | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Conservative management | Cyst aspiration | |||||
| Live birth rate | This primary review outcome was not reported in any of the included studies | Not estimable | ||||
| Adverse events rate | This primary review outcome was not reported in any of the included studies | Not estimable | ||||
| Clinical pregnancy rate | 62 per 1,000 | 72 per 1,000 (21 to 220) | OR 1.19 (0.33 to 4.29) | 159 | ⊕⊝⊝⊝ | |
| Number of follicles recruited | The mean number of follicles recruited in the cyst aspiration groups was | 159 | ⊕⊝⊝⊝ | |||
| Number of oocytes collected | The mean number of oocytes collected in the cyst aspiration groups was | 339 | ⊕⊕⊝⊝ | |||
| Cancellation rate per cycle | 239 per 1,000 | 237 per 1,000 (117 to 423) | OR 0.99 (0.42 to 2.33) | 122 | ⊝⊝⊝⊝ | Each woman had only one cycle |
| *The basis for the assumed risk is the median control group risk across studies. The corresponding risk (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). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Downgraded one level for serious risk of bias; none of the studies adequately described their methods of randomization and allocation concealment | ||||||
| Treatment group | Control | P | |
| Randomised | 90 | 90 | |
| Cycles cancelled prior to egg collection | 2 | 13 | |
| Completed | 88 | 77 | |
| Live birth rate | Not available | Not available | |
| Clinical pregnancy rate | 10.6% | 14.3% | > 0.05 |
| Number of follicles recruited | Not available | Not available | |
| Number of oocytes collected | 5.6±2.1 | 5.2±1.8 | > 0.05 |
| Treatment group | Control | ||
| Randomised | 76 | 46 | |
| Cycle cancelled (poor response) | 17 | 12 | |
| Completed | 59 | 34 | |
| Live birth rate | Not available | Not available | |
| Clinical pregnancy rate | 10.2% | 8.8% | > 0.05 |
| Number of follicles recruited | 5.4 ± 3.1 | 5 ± 2.9 | > 0.05 |
| Number of oocytes collected | 5.6 ± 1.8 | 5.2 ± 2.1 | > 0.05 |
| Treatment group | Control | P | |
| Randomised | 18 | 19 | |
| Discontinued | 0 | 0 | |
| Completed | 18 | 19 | |
| Live birth rate | Not available | Not available | |
| Clinical pregnancy rate | 1 out of 18 (5.56%) | 1 out of 19 (5.26%) | > 0.05 |
| Number of follicles recruited | 10.9 ± 5.33 | 8.9 ± 5.05 | > 0.05 |
| Number of oocytes collected | 7.33 ± 4.0 | 6.7 ± 5.15 | > 0.05 |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Clinical Pregnancy Rate Show forest plot | 2 | 159 | Odds Ratio (M‐H, Fixed, 95% CI) | 1.19 [0.33, 4.29] |
| 2 Number of Follicles Recruited Show forest plot | 2 | 159 | Mean Difference (IV, Fixed, 95% CI) | 0.55 [‐0.48, 1.59] |
| 3 Number of Oocytes Collected Show forest plot | 3 | 339 | Mean Difference (IV, Fixed, 95% CI) | 0.41 [‐0.04, 0.85] |
| 4 Cancellation rate Show forest plot | 1 | 122 | Odds Ratio (M‐H, Fixed, 95% CI) | 0.99 [0.42, 2.33] |
