| Table 5. Grade evidence profile for live birth, clinical pregnancy and pregnancy loss comparing hyaluronic acid enriched medium vs. standard 4 medium for embryo transfer | ||||||||||||
| A.Comparative Summary of Outcomes and Overall Certainty | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Outcome | No. of Studies | HA Enriched Medium (n/N %) |
Standard Medium (n/N %) | Relative Effect (RR, G5% CI) | Absolute Effect (per 1000) |
Overall Certainty | ||||||
| Live birth | 11 | 803/2026 (39.6%) | 697/2037 (34.2%) | RR 1.14 (0.99 to 1.31) | 48 more (from 3 fewer to 106 more) |
⨁◯◯◯Very low a,b,c,d | ||||||
| Clinical Pregnancy | 20 | 1157/2487 (46.5%) | 990/2485 (39.8%) | RR 1.17 (1.06 to 1.29) | 68 more (from 24 more to 116 more) | ⨁◯◯◯Very low a,b,d | ||||||
| Pregnancy loss | 9 | 103/736 (14.0%) | 122/647 (18.9%) | RR 0.75 (0.55 to 1.02) | 47 fewer (from 85 fewer to 4 more) |
⨁◯◯◯Very low a,e | ||||||
| B. Details of Certainty Assessment (GRADE Factors) | ||||||||||||
| Outcome | Study Design | Risk of Bias | Inconsistency | Indirectness | Imprecision | Publication Bias | ||||||
| Live birth | Randomised trials | Serious a | Serious b | not serious | Serious c | none | ||||||
| Clinical Pregnancy | Randomised trials | Serious a | Serious b | not serious | Serious c | none | ||||||
| Pregnancy loss | Randomised trials | Serious a | not serious | not serious | very serious d | none | ||||||
CI: confidence interval; RR: risk ratio; a: Serious risk of bias; b: Serious inconsistency; c: Serious imprecision; d: Very serious imprecision; e: Refers to the specific imprecision factor for pregnancy loss.