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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figuras y tablas -
Figure 1

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

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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 2

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

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Study PRISMA flow chart
Figuras y tablas -
Figure 3

Study PRISMA flow chart

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Forest plot of comparison: 1 Combined oral contraceptive pill (OCP) versus no pretreatment (Rx), outcome: 1.1 Live birth or ongoing pregnancy.
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Combined oral contraceptive pill (OCP) versus no pretreatment (Rx), outcome: 1.1 Live birth or ongoing pregnancy.

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Forest plot of comparison: 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), outcome: 1.2 Pregnancy loss.
Figuras y tablas -
Figure 5

Forest plot of comparison: 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), outcome: 1.2 Pregnancy loss.

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Forest plot of comparison: 3 Oestrogen versus no pretreatment (Rx), outcome: 3.1 Live birth or ongoing pregnancy.
Figuras y tablas -
Figure 6

Forest plot of comparison: 3 Oestrogen versus no pretreatment (Rx), outcome: 3.1 Live birth or ongoing pregnancy.

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Forest plot of comparison: 3 Oestrogen versus no pretreatment (Rx), outcome: 3.2 Pregnancy loss.
Figuras y tablas -
Figure 7

Forest plot of comparison: 3 Oestrogen versus no pretreatment (Rx), outcome: 3.2 Pregnancy loss.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 1 Live birth or ongoing pregnancy.
Figuras y tablas -
Analysis 1.1

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 1 Live birth or ongoing pregnancy.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 2 Pregnancy loss.
Figuras y tablas -
Analysis 1.2

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 2 Pregnancy loss.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 3 Clinical pregnancy rate.
Figuras y tablas -
Analysis 1.3

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 3 Clinical pregnancy rate.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 4 Multiple pregnancy rate.
Figuras y tablas -
Analysis 1.4

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 4 Multiple pregnancy rate.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 5 Ovarian hyperstimulation syndrome rate.
Figuras y tablas -
Analysis 1.5

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 5 Ovarian hyperstimulation syndrome rate.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 6 Number of oocytes retrieved.
Figuras y tablas -
Analysis 1.6

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 6 Number of oocytes retrieved.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 7 Days of gonadotrophin treatment.
Figuras y tablas -
Analysis 1.7

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 7 Days of gonadotrophin treatment.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 8 Amount of gonadotrophins administered.
Figuras y tablas -
Analysis 1.8

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 8 Amount of gonadotrophins administered.

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Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 9 Ovarian cyst formation rate.
Figuras y tablas -
Analysis 1.9

Comparison 1 Combined oral contraceptive pill (COCP) versus no pretreatment (Rx), Outcome 9 Ovarian cyst formation rate.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 1 Live birth or ongoing pregnancy.
Figuras y tablas -
Analysis 2.1

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 1 Live birth or ongoing pregnancy.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 2 Pregnancy loss.
Figuras y tablas -
Analysis 2.2

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 2 Pregnancy loss.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 3 Clinical pregnancy rate.
Figuras y tablas -
Analysis 2.3

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 3 Clinical pregnancy rate.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 4 Multiple pregnancy rate.
Figuras y tablas -
Analysis 2.4

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 4 Multiple pregnancy rate.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 5 Number of oocytes retrieved.
Figuras y tablas -
Analysis 2.5

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 5 Number of oocytes retrieved.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 6 Days of gonadotrophin treatment.
Figuras y tablas -
Analysis 2.6

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 6 Days of gonadotrophin treatment.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 7 Amount of gonadotrophins administered.
Figuras y tablas -
Analysis 2.7

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 7 Amount of gonadotrophins administered.

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Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 8 Ovarian cyst formation rate.
Figuras y tablas -
Analysis 2.8

Comparison 2 Progestogen versus placebo/no pretreatment (Rx), Outcome 8 Ovarian cyst formation rate.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 1 Live birth or ongoing pregnancy.
Figuras y tablas -
Analysis 3.1

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 1 Live birth or ongoing pregnancy.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 2 Pregnancy loss.
Figuras y tablas -
Analysis 3.2

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 2 Pregnancy loss.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 3 Clinical pregnancy rate.
Figuras y tablas -
Analysis 3.3

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 3 Clinical pregnancy rate.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 4 Multiple pregnancies.
Figuras y tablas -
Analysis 3.4

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 4 Multiple pregnancies.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 5 Ovarian hyperstimulation syndrome rate.
Figuras y tablas -
Analysis 3.5

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 5 Ovarian hyperstimulation syndrome rate.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 6 Number of oocytes retrieved.
Figuras y tablas -
Analysis 3.6

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 6 Number of oocytes retrieved.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 7 Days of gonadotrophin treatment.
Figuras y tablas -
Analysis 3.7

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 7 Days of gonadotrophin treatment.

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Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 8 Amount of gonadotrophins administered.
Figuras y tablas -
Analysis 3.8

Comparison 3 Oestrogen versus no pretreatment (Rx), Outcome 8 Amount of gonadotrophins administered.

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Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 1 Live birth or ongoing pregnancy.
Figuras y tablas -
Analysis 4.1

Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 1 Live birth or ongoing pregnancy.

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Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 2 Pregnancy loss.
Figuras y tablas -
Analysis 4.2

Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 2 Pregnancy loss.

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Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 3 Clinical pregnancy rate.
Figuras y tablas -
Analysis 4.3

Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 3 Clinical pregnancy rate.

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Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 4 Multiple pregnancy rate.
Figuras y tablas -
Analysis 4.4

Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 4 Multiple pregnancy rate.

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Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 5 Number of oocytes retrieved.
Figuras y tablas -
Analysis 4.5

Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 5 Number of oocytes retrieved.

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Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 6 Amount of gonadotrophins administered.
Figuras y tablas -
Analysis 4.6

Comparison 4 Combined oral contraceptive pill (COCP) versus progestogen, Outcome 6 Amount of gonadotrophins administered.

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Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 1 Live birth or ongoing pregnancy.
Figuras y tablas -
Analysis 5.1

Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 1 Live birth or ongoing pregnancy.

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Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 2 Pregnancy loss.
Figuras y tablas -
Analysis 5.2

Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 2 Pregnancy loss.

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Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 3 Clinical pregnancy rate.
Figuras y tablas -
Analysis 5.3

Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 3 Clinical pregnancy rate.

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Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 4 Number of oocytes retrieved.
Figuras y tablas -
Analysis 5.4

Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 4 Number of oocytes retrieved.

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Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 5 Days of gonadotropin treatment.
Figuras y tablas -
Analysis 5.5

Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 5 Days of gonadotropin treatment.

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Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 6 Amount of gonadotrophins administered.
Figuras y tablas -
Analysis 5.6

Comparison 5 Combined oral contraceptive pill (COCP) versus oestrogen (Oestr), Outcome 6 Amount of gonadotrophins administered.

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Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 1 Live birth or ongoing pregnancy.
Figuras y tablas -
Analysis 6.1

Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 1 Live birth or ongoing pregnancy.

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Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 2 Clinical pregnancy rate.
Figuras y tablas -
Analysis 6.2

Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 2 Clinical pregnancy rate.

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Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 3 Number of oocytes retrieved.
Figuras y tablas -
Analysis 6.3

Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 3 Number of oocytes retrieved.

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Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 4 Amount of gonadotrophins administered.
Figuras y tablas -
Analysis 6.4

Comparison 6 Progestogen (Prog) versus oestrogen (Oestr), Outcome 4 Amount of gonadotrophins administered.

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Summary of findings for the main comparison. Combined oral contraceptive pill compared to no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Combined oral contraceptive pill compared to no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Population: women undergoing ART

Settings: ART clinic

Intervention: COCP

Comparison: no pretreatment

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk1

Corresponding risk

No pretreatment

COCP

Live birth or ongoing pregnancy

(COCP + Ant vs Ant)

270 per 1000

215 per 1000
(177 to 260)

OR 0.74
(0.58 to 0.95)

1335
(6 studies)

⊕⊕⊕⊝
Moderate2

‐

Live birth or ongoing pregnancy

(COCP + Ant vs Ag)

296 per 1000

273 per 1000
(212 to 345)

OR 0.89
(0.64 to 1.25)

724
(4 studies)

⊕⊕⊕⊝
Moderate3

‐

Pregnancy loss

(COCP + Ant vs Ant)

64 per 1000

85 per 1000
(53 to 134)

OR 1.36
(0.82 to 2.26)

868
(5 studies)

⊕⊕⊕⊝
Moderate3

‐

Pregnancy loss

(COCP + Ant vs Ag)

103 per 1000

44 per 1000
(25 to 76)

OR 0.40
(0.22 to 0.72)

780
(5 studies)

⊕⊕⊕⊝
Moderate3

‐

Multiple pregnancy rate (COCP + Ant vs Ant)

47 per 1000

98 per 1000
(25 to 313)

OR 2.21
(0.53 to 9.26)

125
(2 studies)

⊕⊕⊝⊝
Low4

‐

Multiple pregnancy rate (COCP + Ant vs Ag)

147 per 1000

189 per 1000
(127 to 273)

OR 1.36
(0.85 to 2.19)

546
(4 studies)

⊕⊕⊕⊝
Moderate3

‐

OHSS rate

(COCP + Ant vs Ant)

16 per 1000

16 per 1000

(4 to 52)

OR 0.98

(0.28 to 3.40)

642

(2 studies)

⊕⊕⊝⊝
Low4

‐

OHSS rate

(COCP + Ant vs Ag)

55 per 1000

35 per 1000

(11 to 102)

OR 0.63

(0.20 to 1.96)

290

(2 studies)

⊕⊕⊝⊝
Low4

‐

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. 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).
Ag: agonist; Ant: antagonist; ART: assisted reproductive techniques; COCP: combined oral contraceptive pill; CI: confidence interval; OHSS: ovarian hyperstimulation syndrome; OR: odds ratio.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Mean baseline risk of control group.
2 Downgraded one level for serious risk of bias due to poor reporting of sequence generation and allocation concealment.
3 Downgraded one level for serious imprecision: effect estimate with wide confidence intervals or low event rate (or both).
4 Downgraded two levels for very serious imprecision: small sample size or very low event rate, and effect estimate with wide confidence intervals.

Figuras y tablas -
Summary of findings for the main comparison. Combined oral contraceptive pill compared to no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques
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Summary of findings 2. Progestogen compared to placebo or no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Progestogen compared to placebo or no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Patient or population: ovarian stimulation protocols for women undergoing ART

Settings:

Intervention: progestogen

Comparison: placebo or no pretreatment

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk1

Corresponding risk

Placebo or no pretreatment

Prog

Live birth or ongoing pregnancy

(Prog + Ag vs Ag)

170 per 1000

217 per 1000
(124 to 352)

OR 1.35
(0.69 to 2.65)

222
(2 studies)

⊕⊕⊝⊝
Low2

‐

Live birth or ongoing pregnancy (Prog + Ant vs Ant)

292 per 1000

217 per 1000
(69 to 512)

OR 0.67
(0.18 to 2.54)

47
(1 study)

⊕⊕⊝⊝
Low2

‐

Pregnancy loss

(Prog + Ag vs Ag)

36 per 1000

78 per 1000
(24 to 220)

OR 2.26
(0.67 to 7.55)

222
(2 studies)

⊕⊕⊝⊝
Low2

‐

Pregnancy loss

(Prog + Ant vs Ant)

208 per 1000

86 per 1000
(16 to 354)

OR 0.36
(0.06 to 2.09)

47
(1 study)

⊕⊕⊝⊝
Low2

‐

Multiple pregnancy rate

(Prog + Ag vs Ag)

No data available

‐

‐

Multiple pregnancy rate

(Prog + Ant vs Ant)

42 per 1000

44 per 1000
(3 to 438)

OR 1.05
(0.06 to 17.76)

47
(1 study)

⊕⊕⊝⊝
Low2

‐

OHSS rate

(Prog + Ag vs Ag)

No data available

‐

‐

OHSS rate

(Prog + Ant vs Ant)

No data available

‐

‐

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. 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).
Ag: agonist; Ant: antagonist; ART: assisted reproductive techniques; CI: confidence interval; OHSS: ovarian hyperstimulation syndrome; OR: odds ratio; Prog: progestogen.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Mean baseline risk of control group.
2 Downgraded two levels for very serious imprecision: small sample size and effect estimate with wide confidence intervals.

Figuras y tablas -
Summary of findings 2. Progestogen compared to placebo or no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques
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Summary of findings 3. Oestrogen compared to no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Oestrogencompared to no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

Patient or population: ovarian stimulation protocols for women undergoing ART

Settings:

Intervention: oestrogen

Comparison: no pretreatment

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk1

Corresponding risk

No pretreatment

Oestr

Live birth or ongoing pregnancy

(Oestr + Ant vs Ant)

299 per 1000

252 per 1000
(184 to 333)

OR 0.79
(0.53 to 1.17)

502
(2 studies)

⊕⊕⊕⊝
Moderate2

‐

Live birth or ongoing pregnancy

(Oestr + Ant vs Ag)

350 per 1000

322 per 1000
(215 to 447)

OR 0.88
(0.51 to 1.5)

242
(2 studies)

⊕⊝⊝⊝
Very low3,4

‐

Pregnancy loss

(Oestr + Ant vs Ant)

208 per 1000

40 per 1000
(5 to 279)

OR 0.16
(0.02 to 1.47)

49
(1 study)

⊕⊝⊝⊝
Very low3,4

‐

Pregnancy loss

(Oestr + Ant vs Ag)

72 per 1000

110 per 1000
(46 to 240)

OR 1.59
(0.62 to 4.06)

220
(1 study)

⊕⊝⊝⊝
Very low3,4

‐

Multiple pregnancy rate

(Oestr + Ant vs Ant)

No data available

‐

‐

Multiple pregnancy rate

(Oestr + Ant vs Ag)

Not calculable ‐ see comment

OR 2.24
(0.09 to 53.59)

22
(1 study)

⊕⊝⊝⊝
Very low3,4

Only 2 events (both in oestrogen group)

OHSS rate

(Oestr + Ant vs Ant)

No data available

‐

‐

OHSS rate

(Oestr + Ant vs Ag)

18 per 1000

27 per 1000

(5 to 147)

OR 1.54

(0.25 to 9.42)

220

(1 study)

⊕⊝⊝⊝
Very low3,4

‐

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. 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).
Ag: agonist; Ant: antagonist; ART: assisted reproductive techniques; CI: confidence interval; Oestr: oestrogen; OHSS: ovarian hyperstimulation syndrome; OR: odds ratio.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Mean baseline risk of control group.
2 Downgraded one level for serious imprecision: effect estimate with wide confidence intervals.
3 Downgraded one level for serious risk of bias due to poor reporting on allocation concealment or high attrition (or both).
4 Downgraded two levels for very serious imprecision: small sample size and effect estimate with wide confidence intervals.

Figuras y tablas -
Summary of findings 3. Oestrogen compared to no pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques
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Comparison 1. Combined oral contraceptive pill (COCP) versus no pretreatment (Rx)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Live birth or ongoing pregnancy Show forest plot

8

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 COCP + antagonist (Ant) vs Ant

6

1335

Odds Ratio (M‐H, Fixed, 95% CI)

0.74 [0.58, 0.95]

1.2 COCP + Ant vs agonist (Ag)

4

724

Odds Ratio (M‐H, Fixed, 95% CI)

0.89 [0.64, 1.25]

1.3 COCP + Ant vs Ant, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.71 [0.61, 4.79]

1.4 COCP + Ant vs Ag, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.13 [0.43, 2.98]

2 Pregnancy loss Show forest plot

8

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 COCP + Ant vs Ant

5

868

Odds Ratio (M‐H, Fixed, 95% CI)

1.36 [0.82, 2.26]

2.2 COCP + Ant vs Ag

5

780

Odds Ratio (M‐H, Fixed, 95% CI)

0.40 [0.22, 0.72]

2.3 COCP + Ant vs Ant, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

2.05 [0.18, 23.59]

2.4 COCP + Ant vs Ag, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.13, 7.47]

3 Clinical pregnancy rate Show forest plot

8

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 COCP + Ant vs Ant

5

740

Odds Ratio (M‐H, Fixed, 95% CI)

0.85 [0.63, 1.15]

3.2 COCP + Ant vs Ag

4

546

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.59, 1.20]

3.3 COCP + Ant vs Ant, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.85 [0.69, 4.97]

3.4 COCP + Ant vs Ag, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.44, 2.83]

4 Multiple pregnancy rate Show forest plot

5

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 COCP + Ant vs Ant

2

125

Odds Ratio (M‐H, Fixed, 95% CI)

2.21 [0.53, 9.26]

4.2 COCP + Ant vs Ag

4

546

Odds Ratio (M‐H, Fixed, 95% CI)

1.36 [0.85, 2.19]

4.3 COCP + Ant vs Ant, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

2.11 [0.36, 12.24]

4.4 COCP + Ant vs Ag, low response

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

1.37 [0.29, 6.56]

5 Ovarian hyperstimulation syndrome rate Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 COCP + Ant vs Ant

2

642

Odds Ratio (M‐H, Fixed, 95% CI)

0.98 [0.28, 3.40]

5.2 COCP + Ant vs Ag

2

290

Odds Ratio (M‐H, Fixed, 95% CI)

0.63 [0.20, 1.96]

6 Number of oocytes retrieved Show forest plot

8

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7 Days of gonadotrophin treatment Show forest plot

8

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

7.1 COCP + Ant vs Ant

6

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 COCP + Ant vs Ag

4

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.3 COCP + Ant vs Ant, low response

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.4 COCP + Ant vs Ag, low response

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Amount of gonadotrophins administered Show forest plot

8

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 COCP + Ant vs Ant

7

1275

Mean Difference (IV, Fixed, 95% CI)

190.10 [134.91, 245.28]

8.2 COCP + Ant vs Ag

3

496

Mean Difference (IV, Fixed, 95% CI)

9.96 [‐104.09, 124.02]

8.3 COCP + Ant vs Ant, low response

1

80

Mean Difference (IV, Fixed, 95% CI)

20.0 [‐165.39, 205.39]

8.4 COCP + Ant vs Ag, low response

1

80

Mean Difference (IV, Fixed, 95% CI)

‐349.0 [‐537.92, ‐160.08]

9 Ovarian cyst formation rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 COCP + Ant vs Ant

1

64

Odds Ratio (M‐H, Fixed, 95% CI)

0.47 [0.08, 2.75]
Figuras y tablas -
Comparison 1. Combined oral contraceptive pill (COCP) versus no pretreatment (Rx)
Ir a la tabla de la revisión
Comparison 2. Progestogen versus placebo/no pretreatment (Rx)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Live birth or ongoing pregnancy Show forest plot

4

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Progestogen (Prog) + agonist (Ag) vs Ag

2

222

Odds Ratio (M‐H, Fixed, 95% CI)

1.35 [0.69, 2.65]

1.2 Prog + antagonist (Ant) vs Ant

1

47

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.18, 2.54]

1.3 Prog + gonadotrophin (Gon) vs Gon

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.63 [0.09, 4.23]

2 Pregnancy loss Show forest plot

4

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Prog + Ag vs Ag

2

222

Odds Ratio (M‐H, Fixed, 95% CI)

2.26 [0.67, 7.55]

2.2 Prog + Ant vs Ant

1

47

Odds Ratio (M‐H, Fixed, 95% CI)

0.36 [0.06, 2.09]

2.3 Prog + Gon vs Gon

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

1.0 [0.06, 17.12]

3 Clinical pregnancy rate Show forest plot

5

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Prog + Ag vs Ag

3

374

Odds Ratio (M‐H, Fixed, 95% CI)

1.99 [1.20, 3.28]

3.2 Prog + Ant vs Ant

1

47

Odds Ratio (M‐H, Fixed, 95% CI)

0.52 [0.16, 1.71]

3.3 Prog + Gon vs Gon

1

42

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.14, 3.64]

4 Multiple pregnancy rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Prog + Ant vs Ant

1

47

Odds Ratio (M‐H, Fixed, 95% CI)

1.05 [0.06, 17.76]

5 Number of oocytes retrieved Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 Prog + Ag vs Ag

2

222

Mean Difference (IV, Fixed, 95% CI)

‐0.52 [‐2.07, 1.02]

5.2 Prog + Ant vs Ant

1

47

Mean Difference (IV, Fixed, 95% CI)

2.70 [‐0.98, 6.38]

5.3 Prog + Gon vs Gon

1

29

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.57, 0.57]

6 Days of gonadotrophin treatment Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Prog + Ag vs Ag

2

222

Mean Difference (IV, Fixed, 95% CI)

0.11 [‐0.30, 0.52]

7 Amount of gonadotrophins administered Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Prog + Ant vs Ant

1

47

Mean Difference (IV, Fixed, 95% CI)

276.0 [‐75.53, 627.53]

8 Ovarian cyst formation rate Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 Prog + Ag vs Ag

3

374

Odds Ratio (M‐H, Fixed, 95% CI)

0.16 [0.08, 0.32]
Figuras y tablas -
Comparison 2. Progestogen versus placebo/no pretreatment (Rx)
Ir a la tabla de la revisión
Comparison 3. Oestrogen versus no pretreatment (Rx)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Live birth or ongoing pregnancy Show forest plot

4

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Oestrogen (Oestr) + antagonist (Ant) vs Ant

2

502

Odds Ratio (M‐H, Fixed, 95% CI)

0.79 [0.53, 1.17]

1.2 Oestr + Ant vs agonist (Ag)

2

242

Odds Ratio (M‐H, Fixed, 95% CI)

0.88 [0.51, 1.50]

2 Pregnancy loss Show forest plot

2

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Oestr + Ant vs Ant

1

49

Odds Ratio (M‐H, Fixed, 95% CI)

0.16 [0.02, 1.47]

2.2 Oestr + Ant vs Ag

1

220

Odds Ratio (M‐H, Fixed, 95% CI)

1.59 [0.62, 4.06]

3 Clinical pregnancy rate Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Oestr + Ant vs Ant

4

688

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.66, 1.24]

3.2 Oestr + Ant vs Ag

2

242

Odds Ratio (M‐H, Fixed, 95% CI)

0.76 [0.45, 1.27]

4 Multiple pregnancies Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Oestr + Ant vs Ag

1

22

Odds Ratio (M‐H, Fixed, 95% CI)

2.24 [0.09, 53.59]

5 Ovarian hyperstimulation syndrome rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Oestr + Ant vs Ag

1

220

Odds Ratio (M‐H, Fixed, 95% CI)

1.54 [0.25, 9.42]

6 Number of oocytes retrieved Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Oestr + Ant vs Ant

2

139

Mean Difference (IV, Fixed, 95% CI)

2.23 [0.71, 3.75]

6.2 Oestr + Ant vs Ag

1

22

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐4.47, 5.27]

7 Days of gonadotrophin treatment Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Oestr + Ant vs Ant

2

529

Mean Difference (IV, Fixed, 95% CI)

0.83 [0.58, 1.08]

7.2 Oestr + Ant vs Ag

1

22

Mean Difference (IV, Fixed, 95% CI)

‐2.5 [‐4.07, ‐0.93]

8 Amount of gonadotrophins administered Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 Oestr + Ant vs Ant

4

668

Mean Difference (IV, Fixed, 95% CI)

168.35 [111.53, 225.17]

8.2 Oestr + Ant vs Ag

1

22

Mean Difference (IV, Fixed, 95% CI)

‐16.0 [‐470.12, 438.12]
Figuras y tablas -
Comparison 3. Oestrogen versus no pretreatment (Rx)
Ir a la tabla de la revisión
Comparison 4. Combined oral contraceptive pill (COCP) versus progestogen

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Live birth or ongoing pregnancy Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 COCP + antagonist (Ant) vs progestogen (Prog) + Ant

1

44

Odds Ratio (M‐H, Fixed, 95% CI)

0.6 [0.12, 2.89]

2 Pregnancy loss Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 COCP + Ant vs Prog + Ant

1

44

Odds Ratio (M‐H, Fixed, 95% CI)

1.11 [0.14, 8.64]

3 Clinical pregnancy rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 COCP + Ant vs Prog + Ant

1

44

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.19, 2.73]

4 Multiple pregnancy rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 COCP + Ant vs Prog + Ant

1

44

Odds Ratio (M‐H, Fixed, 95% CI)

2.32 [0.19, 27.59]

5 Number of oocytes retrieved Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 COCP + Ant vs Prog + Ant

1

44

Mean Difference (IV, Fixed, 95% CI)

1.40 [‐3.24, 6.04]

6 Amount of gonadotrophins administered Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 COCP + Ant vs Prog + Ant

1

44

Mean Difference (IV, Fixed, 95% CI)

164.0 [‐249.03, 577.03]
Figuras y tablas -
Comparison 4. Combined oral contraceptive pill (COCP) versus progestogen
Ir a la tabla de la revisión
Comparison 5. Combined oral contraceptive pill (COCP) versus oestrogen (Oestr)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Live birth or ongoing pregnancy Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 COCP + antagonist (Ant) vs Oestr + Ant

2

146

Odds Ratio (M‐H, Fixed, 95% CI)

1.11 [0.54, 2.29]

1.2 COCP + agonist (Ag) vs Oestr + Ant

1

25

Odds Ratio (M‐H, Fixed, 95% CI)

0.08 [0.01, 0.79]

2 Pregnancy loss Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 COCP + Ag vs Oestr + Ant

1

25

Odds Ratio (M‐H, Fixed, 95% CI)

1.09 [0.06, 19.63]

3 Clinical pregnancy rate Show forest plot

3

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 COCP + Ant vs Oestr + Ant

2

146

Odds Ratio (M‐H, Fixed, 95% CI)

1.19 [0.60, 2.37]

3.2 COCP + Ag vs Oestr + Ant

1

25

Odds Ratio (M‐H, Fixed, 95% CI)

0.13 [0.02, 0.82]

4 Number of oocytes retrieved Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 COCP + Ant vs Oestr + Ant

1

46

Mean Difference (IV, Fixed, 95% CI)

0.90 [‐3.59, 5.39]

5 Days of gonadotropin treatment Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 COCP + Ant vs Oestr + Ant

1

100

Mean Difference (IV, Fixed, 95% CI)

‐0.60 [‐1.23, 0.03]

6 Amount of gonadotrophins administered Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

6.1 COCP + Ant vs Oestr + Ant

2

146

Mean Difference (IV, Random, 95% CI)

181.56 [‐344.73, 707.86]
Figuras y tablas -
Comparison 5. Combined oral contraceptive pill (COCP) versus oestrogen (Oestr)
Ir a la tabla de la revisión
Comparison 6. Progestogen (Prog) versus oestrogen (Oestr)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Live birth or ongoing pregnancy Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Prog + antagonist (Ant) vs Oestr + Ant

1

48

Odds Ratio (M‐H, Fixed, 95% CI)

2.04 [0.43, 9.70]

2 Clinical pregnancy rate Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Prog + Ant vs Oestr + Ant

1

48

Odds Ratio (M‐H, Fixed, 95% CI)

2.30 [0.57, 9.22]

3 Number of oocytes retrieved Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 Prog + Ant vs Oestr + Ant

1

48

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐4.55, 3.55]

4 Amount of gonadotrophins administered Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 Prog + Ant vs Oestr + Ant

1

48

Mean Difference (IV, Fixed, 95% CI)

310.0 [‐32.30, 652.30]
Figuras y tablas -
Comparison 6. Progestogen (Prog) versus oestrogen (Oestr)
Ir a la tabla de la revisión