다낭성난소증후군으로 인한 불임 여성에서 경구 배란유도제의 효능: 메타메타분석A Meta-Meta-Analysis: Effectiveness of Oral Ovulation Induction Agents for Infertile Women with Polycystic Ovary Syndrome
- Other Titles
- A Meta-Meta-Analysis: Effectiveness of Oral Ovulation Induction Agents for Infertile Women with Polycystic Ovary Syndrome
- Authors
- 이지은; 이소영; 정은아; 김미리; 조은
- Issue Date
- Nov-2023
- Publisher
- 한국보건사회약료경영학회
- Keywords
- meta-meta-analysis; polycystic ovary syndrome; infertility; ovulation induction
- Citation
- 한국보건사회약료경영학회지, v.11, no.2, pp 88 - 97
- Pages
- 10
- Journal Title
- 한국보건사회약료경영학회지
- Volume
- 11
- Number
- 2
- Start Page
- 88
- End Page
- 97
- URI
- https://scholarworks.sookmyung.ac.kr/handle/2020.sw.sookmyung/159535
- ISSN
- 2508-6596
- Abstract
- Background: Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. Clomiphene citrate (CC), letrozole (LE), metformin (M), and CC plus M (CCM) are available therapeutic options for PCOS-related infertility. Therefore, we conducted a meta-meta-analysis to provide summarized effect sizes for reproductive outcomes and to assist health providers in selecting appropriate ovulation induction agents (OIAs).
Methods: This study used three databases to perform a meta-meta-analysis to evaluate the pooled estimates of ovulation rate (OR), live birth (LB), and pregnancy (P).
Results: A total of 17 meta-analyses and 71 primary studies were included in this overview. There was a high overlap between primary studies, and the corrected covered area score was 10.12%. Compared to CC, LE significantly improved the OR per patient (RR 1.30, 95%CI 1.02-1.65), LB (RR 1.52, 95%CI 1.37-1.69), and P (RR 1.24, 95%CI 1.09-1.43). CCM resulted in a 1.30 times higher pregnancy rate than CC (95%CI 1.21-1.40). M was no more effective than CC in OR (RR 0.73, 95%CI 0.63-0.86) and LB (RR 0.85, 95%CI 0.75-0.97).
Conclusion: Patients with PCOS-related infertility treated with LE have a higher chance of ovulation, live birth, and pregnancy than those treated with CC. CCM significantly increased the pregnancy rate compared to CC, and M monotherapy was not competitive with CC for reproductive outcomes.
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