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Health-related quality-of-life among patients with premature ovarian insufficiency: a systematic review and meta-analysis

Journal article
Authors X. T. Li
P.Y. Li
Y. Liu
H. S. Yang
L. Y. He
Y. G. Fang
J. Liu
B. Y. Liu
John Chaplin
Published in Quality of Life Research
Volume 29
Pages 19–36
ISSN 0962-9343
Publication year 2020
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 19–36
Language en
Keywords Surveys and questionnaires, Menstruation disturbance, Gynaecology, Women's health, female sexual function, ces-d scale, self-esteem, negative affect, social support, index fsfi, women, reliability, questionnaire, validation, Health Care Sciences & Services, Public, Environmental & Occupational, Health
Subject categories Obstetrics, Gynecology and Reproductive Medicine


Purpose To systematically review studies investigating health-related quality-of-life (HrQoL) in patients with premature ovarian insufficiency (POI), to examine questionnaires used and to conduct a meta-analysis of control studies with normal ovarian function. Methods Data sources: PubMed, Embase, Web of science, CNKI, and CQVIP, searched from inception until June 2018. The search strategy was a combination of medical (e.g. POI), subjective (e.g. well-being) and methodological (e.g. questionnaires) keywords. PRISMA guidelines were used to assess outcome data quality/validity by one reviewer, verified by a second reviewer. Risk of bias within studies was evaluated. A meta-analysis compared HrQoL in patients and non-patients. Due to measurement differences in the studies, the effect size was calculated as standard mean difference. Results We identified 6869 HrQoL studies. Nineteen geographically diverse studies met inclusion criteria, dated from 2006, using 23 questionnaires. The meta-analysis included six studies with 645 POI participants (age 33.3 ± 5.47) and 492 normal-ovarian control subjects (age 32.87 ± 5.61). Medium effect sizes were found for lower overall HrQoL (pooled SMD = − 0.73, 95% CI − 0.94, − 0.51; I2 = 54%) and physical function (pooled SMD = − 0.54, 95% CI − 0.69, − 0.39; I2 = 55%). Heterogeneity was investigated. Effect sizes varied for sexual function depending on the measure (SMD = − 0.27 to − 0.74), overall HrQoL (SF-36) had the largest effect size (− 0.93) in one study. The effect sizes for psychological and social HrQoL were small. Conclusion POI is associated with low-to-medium effect size on HrQoL compared to normal ovarian controls. The greatest effects are found in general HrQoL and most sexual function areas. Condition-specific questionnaires and RCTs are recommended for further investigation.

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