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Type: Journal article
Title: Interventions for endometriosis-related infertility: a systematic review and network meta-analysis
Author: Hodgson, R.M.
Lee, H.L.
Wang, R.
Mol, B.W.
Johnson, N.
Citation: Fertility and Sterility, 2020; 113(2):374-382.e2
Publisher: Elsevier
Issue Date: 2020
ISSN: 0015-0282
Statement of
Ruth Mary Hodgson, Hui Linn Lee, Rui Wang, Ben Williem Mol, Neil Johnson
Abstract: OBJECTIVE: To compare the effectiveness of different treatments for women with endometriosis-related infertility. DESIGN: A systematic review and network meta-analysis of randomized controlled trials (RCTs). SETTING: Not applicable. PATIENT(S): Women with endometriosis confirmed by laparoscopy with associated infertility. INTERVENTION(S): An extensive electronic search of the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE,, and Embase. MAIN OUTCOME MEASURE(S): Clinical pregnancy, live birth rate, miscarriage, and adverse events. RESULT(S): A total of 4,252 trials/abstracts were identified through the literature search, of which we included 36 trials in the systematic review and 26 trials reporting on 2,245 women with endometriosis-related infertility in the network meta-analysis. Network meta-analysis showed that compared with placebo, surgical laparoscopy alone (odds ratio = 1.63; 95% confidence interval, 1.13-2.35) or GnRH agonist alone (odds ratio = 1.68; 95% confidence interval, 1.07-2.46) results in higher odds of pregnancy. The evidence on the other interventions versus placebo or on the secondary outcomes including live birth, miscarriage, and adverse events is insufficient. CONCLUSION(S): The most important conclusion is that more RCTs are needed to clarify the relative effectiveness of treatments for endometriosis-related infertility, ideally comparing interventions to existing recommended interventions such as surgical laparoscopy. In addition, further RCTs comparing IVF and IUI to other treatments are essential. REGISTRATION NUMBER: PROSPERO registration number, CRD42018087572.
Keywords: Endometriosis; infertility; interventions
Rights: © 2019 American Society for Reproductive Medicine, Published by Elsevier Inc.
RMID: 1000016880
DOI: 10.1016/j.fertnstert.2019.09.031
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Appears in Collections:Obstetrics and Gynaecology publications

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