Use of Fertility Drugs and Risk of Ovarian Cancer: Danish Population Based Cohort Study (original) (raw)
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Use of fertility drugs and risk of ovarian cancer
Current Opinion in Obstetrics and Gynecology, 2014
The potential association between fertility drugs and risk of ovarian cancer has been analysed using data from a case-control study conducted between January 1992 and September 1999 in four Italian areas. Cases were 1031 women (median age 56, range 18-79 years) with incident, histologically confirmed epithelial ovarian cancer. Controls were 2411 women (median age 57, range 17-79 years) residing in the same geographical areas and admitted to the same network of hospitals for cases for a wide spectrum of acute, non neoplastic, non hormone-related conditions. A total of 15 cases and 26 controls reported use of fertility drugs. The corresponding odds ratio (OR) was 1.3 (95% confidence interval 0.7-2.5). The OR was 1.2 for women reporting last use <25 years before interview and 1.3 for >25 years. Considering calendar year at use, the OR was non-significantly above unity for women reporting fertility drug use after 1970. The OR was 0.6 among nulliparous women and 1.9 among parous ones.
Fertility drugs, reproductive strategies and ovarian cancer risk
Journal of Ovarian Research, 2014
Several adverse effects have been related to infertility treatments, such as cancer development. In particular, the relationship between infertility, reproductive strategies, and risk of gynecological cancers has aroused much interest in recent years. The evaluation of cancer risk among women treated for infertility is very complex, mainly because of many factors that can contribute to occurrence of cancer in these patients (including parity status). This article addresses the possible association between the use of fertility treatments and the risk of ovarian cancer, through a scrupulous search of the literature published thus far in this field. Our principal objective was to give more conclusive answers on the question whether the use of fertility drug significantly increases ovarian cancer risk. Our analysis focused on the different types of drugs and different treatment schedules used. This study provides additional insights regarding the long-term relationships between fertility drugs and risk of ovarian cancer.
Fertility drugs and ovarian cancer risk: a critical review of the literature
Annals of the New York …, 2010
There is evidence that medications used for ovarian stimulation and in vitro fertilization may be associated with ovarian cancer. In this review, we attempt to describe this relationship according to the most recent epidemiologic data and to present the possible mechanisms on the molecular level that could potentially explain this correlation. Currently there is no proven relationship between any type of ovarian cancer and drugs used for infertility treatment. Overall, infertile women have increased risk for ovarian malignancies. Nulligravidas that received treatment are at increased risk for ovarian malignancy as compared to women that conceived after treatment. More studies with the appropriate statistical power and follow-up time, as well as with better adjustment for confounding factors, which coexist in infertile patients, are required to evaluate accurately the long-term effects of these drugs and procedures.
Fertility drugs and the risk of breast and ovarian cancers: results of a long-term follow-up study
Fertility and Sterility, 1999
Objective: To investigate a possible linkage between the use of fertility drugs for infertility and the risk of breast and ovarian cancers.Design: Long-term, historic-prospective study.Setting: Fertility clinic in a university hospital.Patient(s): Files of 1,197 infertile women with a mean (± SD) follow-up of 17.9 ± 5 years (21,407 person-years) were reviewed. Diagnoses, number of courses, and dosage of fertility drugs
Fertility and Sterility, 2013
Objective: To examine the relationship of ovulation-inducing drugs and ovarian cancer. Design: Retrospective cohort study, with additional follow-up since initial report. Setting: Five large reproductive endocrinology practices. Patient(s): In a retrospective cohort of 9,825 women evaluated for infertility at five clinical sites in the United States between 1965 and 1988 with follow-up through 2010, we examined the relationship of ovulation-inducing drugs and ovarian cancer (n ¼ 85). Intervention(s): None. Main Outcome Measure(s): Hazard rate ratios (RR) and 95% confidence intervals (CI) for ovarian cancer. Result(s): Among women evaluated for infertility, there was no association of ovarian cancer risk with ever use of clomiphene citrate (CC) (adjusted RR 1.34, 95% CI 0.86-2.07) or gonadotropins (RR 1.00, 95% CI 0.48-2.08) and no evidence that any of several more detailed subgroups of usage were related to an increased risk with one exception: women who used CC and remained nulligravid did demonstrate much higher risks than those who successfully conceived compared with nonusers (respectively, RR 3.63, 95% CI 1.36-9.72 vs. RR 0.88, 95% CI 0.47-1.63). Conclusion(s): Our overall results were reassuring and consistent with other studies. A reason for an association between CC use and ovarian cancer among persistently nulligravid women remains to be determined. Given the large and increasing number of women treated with ovulation-inducing drugs, the increased risk of ovarian cancer among the subset of women who remained nulligravid should be further monitored.
Fertility drugs and cancer: a guideline
Fertility and Sterility, 2016
Methodological limitations in studying the association between the use of fertility drugs and cancer include the inherent increased risk of cancer in women who never conceive, the low incidence of most of these cancers, and that the age of diagnosis of cancer typically is many years after fertility drug use. Based on available data, there does not appear to be a meaningful increased risk of invasive ovarian cancer, breast cancer, or endometrial cancer following the use of fertility drugs. Several studies have shown a small increased risk of borderline ovarian tumors; however, there is insufficient consistent evidence that a particular fertility drug increases the risk of borderline ovarian tumors, and any absolute risk is small. Given the available literature, patients should be counseled that infertile women may be at an increased risk of invasive ovarian, endometrial, and breast cancer; however, use of fertility drugs does not appear to increase this risk.
Association between fertility drugs and gynecologic cancers, breast cancer, and childhood cancers
Acta Obstetricia et Gynecologica Scandinavica, 2004
Ovulation-inducing drugs have been widely used for various types of infertility since the beginning of 1960s and their use increases day by day parallel to the success achieved in fertility treatment. However, the researches performed in the last two decades have begun to discuss about the safety of these drugs and the risks associated with their use. Especially, the potential neoplastic effects of these drugs are increasingly questioned. The studies have discussed whether there is an association between the exposure to ovulation-inducing drugs and the incidence of various cancers. Moreover, several studies have been performed to reveal whether there is an increased risk of childhood cancers in children conceived after fertility treatment. The point we reached through the available data is that the risk of breast, uterine and invasive ovarian cancers is not increased, but the risk of borderline ovarian tumors might increase after such a therapy. The risk of cancer has been found similar for children conceived after fertility treatment and those conceived naturally. It should also be kept in mind that cancers are overdiagnosed in infertile women population because of the close medical surveillance, which may also contribute to the early detection of cancers. Although it is still early to state the last words on this topic, the possible association should be addressed when obtaining an informed consent before starting treatment.
Risk of Ovarian Cancer After Treatment for Infertility
Journal of Health, Medicine and Nursing, 2020
Background: Ovarian cancer is the most frequent cause of death from gynecologic malignancies in the world. Ovarian cancer is predominantly a disease of postmenopausal period, with a median age at diagnosis of 59 years. In recent years, there have been many debates about the relationship between fertility medication and cancer. Due to the lack of comprehensive study of this matter, and as understanding the relationship between the use of fertility drugs and cancer is of importance, the present study was conducted to investigate the relationship between infertility drugs and cancer in women. Objective: To determine the risk of ovarian cancer after treatment of infertility. Study Selection: Multiple articles were reviewed. Prospective studies and case reports were excluded from the data. Retrospective studies were included in the study. Methods and Materials: A review of the scientific literature concerning the association between the use of fertility treatments and the risk of ovarian cancer was done. In this study, digital databases including PubMed, EMBASE and Google scholar were searched. The survey was carried out using keywords such as "infertility", " ovarian cancer risk", "gynecological cancer", "gynecological cancer risk", "cancer risk", "in vitro fertilization", "progesterone", "fertility drugs", "infertility treatment", variously associated together. Results: Using the search criteria, 25 researches were examined based on the title and abstract. All the 25 studies were considered in their full versions. Of these works, including literature reviews or meta-analysis reports, it was concluded that infertility treatment has a positive relationship with ovarian cancer. Conclusion: The results of this study suggest that fertility drug usage significantly contribute to overall risk of ovarian cancer when adjusting for known confounding factors. In the next years, the incidence of female infertility is expected to increase. A lot of new drugs are under investigation while other recent drugs are already in current use. More study can be done so that the mortality and mobility could be reduced in the society.
Treatment for infertility and risk of invasive epithelial ovarian cancer
2000
The relationship between the use of fertility drugs and the risk of ovarian cancer was analysed using data from an Italian case-control study. The study comprised 971 women below the age of 75 years with histologically confirmed invasive epithelial ovarian cancer diagnosed within the year before the interview. The controls were 2758 women admitted to the same network of hospitals
Fertility drugs and breast cancer risk
European journal of gynaecological oncology, 2015
Female infertility is a widespread problem in Western countries. During past years, an association between ovarian stimulation in unfertile women and breast cancer risk has been hypothesized. Purpose of the present investigation was to comment the most updated studies about an eventual relationship between fertility drugs and breast cancer risk. The authors performed a review of the current literature regarding the possible association between the use of fertility drugs and the enhanced risk of breast cancer. They searched digital databases including Pubmed, EMBASE, and the Cochrane Library. The literature search was performed using various combinations of keywords. They carefully analyzed only the full versions of all relevant studies. Using various combination of keywords, the authors examined 930 papers. They considered only papers written in English. With these criteria they selected the studies that had been discussed in detail on the text. None of the works commented provides ...