Evidence mapPaperPMID 31247909Full record

ReviewMedical sciences (Basel, Switzerland)2019

A Review of Second- and Third-line Infertility Treatments and Supporting Evidence in Women with Polycystic Ovary Syndrome.

Michael F Costello, Rhonda M Garad, Roger Hart, Hayden Homer, Louise Johnson, Cailin Jordan, Edgar Mocanu, Jie Qiao, Luk Rombauts, Helena J Teede and 3 more

Open access · goldAbstract readReview
In one paragraph

Review in Medical sciences (Basel, Switzerland), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  4. Efficacy of Stop GnRH-Agonist/Antagonist versus GnRH-Antagonist Protocols inInternational journal of fertility & sterility · 2026
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  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 4 countries.

Michael F CostelloUniversity of New South Wales, High St. Kensington, Sydney, NSW 2052, Australia. mfcostello@unsw.edu.au.ORCID 0000-0001-7340-1356
Rhonda M GaradMonash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University and Monash Health, Melbourne, VIC 3168, Australia. rhonda.garad@monash.edu.ORCID 0000-0002-2414-5197
Roger HartDivision of Obstetrics and Gynaecology, The University of Western Australia, University of Western Australia, Crawley, WA 6008, Australia. roger.hart@uwa.edu.au.
Hayden HomerChristopher Chen Oocyte Biology Research Laboratory, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4029, Australia. h.homer@uq.edu.au.
Louise JohnsonVictorian Assisted Reproductive Treatment Authority, Melbourne, VIC 3000, Australia. LJohnson@varta.org.au.
Cailin JordanGenea Hollywood Fertility, Wembley 6014, Australia. Cailin.Jordan@genea.com.au.ORCID 0000-0002-1597-0849
Edgar MocanuRoyal College of Surgeons, Rotunda Hospital, D02 YN77 Dublin, Ireland. emocanu@rcsi.ie.ORCID 0000-0002-3094-4892
Jie QiaoDepartment of Obstetrics and Gynaecology, Medical Center for Human Reproduction, Peking University Third Hospital, Beijing 100191, China. jie.qiao@263.net.ORCID 0000-0003-2126-1376
Luk RombautsDepartment of Obstetrics and Gynaecology, Monash University, Melbourne 3168, Australia. luk.rombauts@monash.edu.ORCID 0000-0003-2656-2792
Helena J TeedeMonash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University and Monash Health, Melbourne, VIC 3168, Australia. helena.teede@monash.edu.ORCID 0000-0001-7609-577X
Eszter VankyDepartment of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 1517 Trondheim, Norway. eszter.vanky@ntnu.no.
Christos A VenetisUniversity of New South Wales, High St. Kensington, Sydney, NSW 2052, Australia. c.venetis@unsw.edu.au.
William L LedgerUniversity of New South Wales, High St. Kensington, Sydney, NSW 2052, Australia. w.ledger@unsw.edu.au.ORCID 0000-0001-6465-4343
UNSW Sydney · AUMonash Health · AUMonash University · AUNorwegian University of Science and Technology · NOPeking University · CNRotunda Hospital · IEThe University of Queensland · AUThe University of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In clomiphene-citrate-resistant anovulatory women with polycystic ovary syndrome (PCOS) and no other infertility factors, either metformin combined with clomiphene citrate or gonadotrophins could be used as a second-line pharmacological therapy, although gonadotrophins are more effective. Gonadotrophins could also be used as a second-line pharmacological therapy in anovulatory women with PCOS and clomiphene-citrate-failure. Laparoscopic ovarian surgery can also be used as a second-line therapy for ovulation induction in anovulatory women with clomiphene-citrate-resistant PCOS and no other infertility factors. The usefulness of letrozole as a second-line pharmacological treatment for ovulation induction in clomiphene-citrate-resistant women with PCOS requires further research. In terms of improving fertility, both pharmacological anti-obesity agents and bariatric surgery should be considered an experimental therapy in anovulatory women with PCOS and no other infertility factors. Where first- or second-line ovulation induction therapies have failed, in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) could be offered as a third-line therapy in women with PCOS in the absence of an absolute indication for IVF/ICSI. For women with PCOS undergoing IVF/ICSI treatment, the gonadotropin-releasing hormone (GnRH) antagonist protocol is preferred and an elective frozen embryo transfer strategy could be considered. In assisted conception units with sufficient expertise, in-vitro maturation (IVM) of oocytes could be offered to women with PCOS.

Indexed as

assisted reproductive technologyinfertilityIVFIVMpolycystic ovary syndromesurgery

Identifiers

PMID31247909
PMCPMC6681353
OpenAlexW2954988595

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.