Letter to the editor

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This letter points out a potential mislabeling in a prior study's forest plot comparing endometrioma surgery and IVF/ICSI outcomes, where the axis appears to incorrectly favor surgery.

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Laursen and Schroll identify a potential graphical error in a previously published systematic review regarding the surgical management of endometriomas for IVF outcomes. They argue that the Forrest plots incorrectly display results favoring surgery, whereas their manual calculation of event rates suggests the data actually favors non-treatment. Although they acknowledge this discrepancy likely does not alter the final conclusions of the original meta-analysis, they urge the journal to verify the figures with the authors. This paper is centrally about endometriosis — specifically addressing the impact of surgical intervention on endometrioma-related infertility.

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Vol.:(0123456789)1 3 Archives of Gynecology and Obstetrics (2019) 299:287 https://doi.org/10.1007/s00404-018-4984-1 LETTER Letter to the editor Jacob Brink Laursen1  · Jeppe Bennekou Schroll1 Received: 16 August 2018 / Accepted: 17 November 2018 / Published online: 7 December 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Dear Editor Recently, we read the article “The effect of surgical man - agement of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and metaanalysis” [1]. It was written by M. Nickkho-Amiry as the lead author and published in your journal. We read it with great interest. Together with my research group, I wrote an article on the same topic, based on almost the same mate- rial and it was published in Acta Obstetricia et Gynecologica Scandinavica in spring 2017 [2]. In Fig. 2 (Forrest Plots examining outcome measures), in the Forrest plot for “Live Birth Rate/cycle”, the axis may have been named wrongly. A quick calculation shows that number of events out of total events in the “Treated Endometrioma”-group of the Bongioanni study equals roughly 26% (29/112 = 0.258). The events out of total events in the “Non Treated Endometrioma”-group of the same study equals 35% (49/142 = 0.345). This must necessarily mean that the result favors no surgery, since the percentage of live birth rates per cycle is higher. This is in contrast to what the plot shows, as this indicates that the result is in favor of surgery (The square is on the “favors surgery”-side of 1). The same appears to go for all the other studies and actually also includes the Forrest plots of “Clinical Preg - nancy/cycle” and “Pregnancy/Cycle”. Based on the results of our own systematic review, it probably will not have any effect on the final result and recommendations, but I hope you will have the opportunity to look into the matter and acquire a comment from the authors. If it turns out that I have misinterpreted the figure, please accept my apologies, and I will of course take any comment from you or the authors into consideration. Kind regards, Jacob Brink Laursen, MD, Senior Registrar Jeppe Schroll, MD Author contributions JBL Manuscript writing/editing; JBS Manuscript editing. Compliance with ethical standards Conflict of interest We declare we have no conflict of interest. References 1. Nickkho-Amiry M, Savant R, Majumder K, Edi-O’sagie E, Akhtar M (2018) The effect of surgical management of endometrioma on the IVF/ICSI outcomes when compared with no treatment? A systematic review and meta-analysis. Arch Gynecol Obstet 297(4):1043–1057. https ://doi.org/10.1007/s0040 4-017-4640-1 2. Brink Laursen J, Schroll JB, Macklon KT, Rudnicki M (2017) Surgery versus conservative management of endometriomas in subfertile women. A systematic review. Acta Obstet Gynecol Scand 96:727–735 * Jacob Brink Laursen [email protected] 1 Hvidovre Hospital, Copenhagen, Denmark

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Female Humans Sperm Injections, Intracytoplasmic

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