Comparing ovulation induction strategies for unexplained infertility: protocol for a systematic review and network...

Area of Science:

• Reproductive Endocrinology and Infertility
• Evidence Synthesis and Meta-Analysis
• Clinical Trial Methodology

Background:

• Unexplained infertility affects 30% of couples, with unclear optimal ovulation induction strategies.
• Current treatments like letrozole, clomiphene citrate, and gonadotropins lack consistent comparative effectiveness and safety data.
• Existing reviews often use pairwise comparisons or include mixed infertility populations.

Purpose of the Study:

• To conduct a systematic review and network meta-analysis (NMA) comparing ovulation induction strategies.
• Specifically focus on treatments for unexplained infertility to determine optimal approaches.
• Provide evidence to guide clinical decision-making for infertile couples.

Main Methods:

• Systematic review and NMA of parallel-group randomized controlled trials (RCTs).
• Inclusion criteria: women aged 18-40 with unexplained infertility, various ovulation induction agents (letrozole, clomiphene citrate, gonadotropins), with or without IUI.
• Primary outcome: live birth rate; secondary outcomes: pregnancy, ovulation, multiple pregnancy, OHSS, etc. Comprehensive database searches and risk of bias assessment (RoB-2).

Main Results:

• This section will be populated upon completion of the review and analysis.
• The NMA will provide comparative effectiveness and safety data for different ovulation induction strategies.
• Certainty of evidence will be assessed using the CINeMA framework.

Conclusions:

• This NMA will synthesize evidence on ovulation induction for unexplained infertility.
• Findings will clarify the comparative effectiveness and safety of various treatment options.
• The results aim to inform clinical practice and improve outcomes for couples with unexplained infertility.