, Etudes)exclues)(n=19))
, M)Intervention)mal)définie):)5)
, M)Fertilité)mal)définie):)7)
, Données)manquantes):)4)
, M)Inclusion)de)cancers):)2)
, Données)déjà)publiées):)1)
, Études)incluses)dans)la)synthèse) quantitative)(n=7))
, , 2013.
, , 2012.
, , 2004.
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, , p.métaDanalyse, 1994.
,
, Le biais de performance est dû au caractère rétrospectif des études ne permettant pas d'inclure une population exposée uniformément au traitement étudié. S'ajoutent à ces biais systématiques des facteurs confondants tels que les données de fertilité concernant les partenaires masculins qui devraient être recherchées et plus explicitement exposées pour améliorer l'imputabilité de l'AIA dans la survenue d'une infertilité
hétérogénéité des essais inclus dans la méta-analyse limitait l'interprétation des résultats. S'il est difficile de réaliser une méta-analyse d'essais parfaitement homogènes, l'analyse de sensibilité a permis de déterminer l'impact de l'étude d'Olsen dans l'hétérogénéité (42). Cependant, si son retrait de la méta-analyse abaissait légèrement le risque relatif d'infertilité après AIA ,
, Au mieux, une méta-analyse sur données individuelles, issues d'essais randomisés, permettrait d'étudier l'interaction des différents facteurs pour annuler leur effet. Une analyse sur données publiées permettrait aussi de réaliser des analyses de sous-groupes pour déterminer des facteurs prédictifs d
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