Article

Induction of ovulation and ovarian cancer: A critical review of the literature

Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York, USA.
Fertility and sterility (Impact Factor: 4.59). 05/2006; 85(4):819-26. DOI: 10.1016/j.fertnstert.2005.08.061
Source: PubMed

ABSTRACT

To critically examine the possible association between ovulation-inducing drugs and ovarian cancer.
Medline literature review and cross-reference of published data.
The studies that have adjusted for the effects of confounding factors such as duration of oral contraceptive use and number of pregnancies have noted an increased risk of ovarian cancer among infertile women who remain childless despite long periods of unprotected intercourse. Whether such women are at risk due to the primary basis for their infertility or factors such as ovulation-inducing drugs, has been the subject of several studies. Overall, the findings on ovarian cancer (especially invasive epithelial and non-epithelial) risk associated with fertility drug treatment are reassuring. However, a stronger association between fertility drug use and borderline tumors of the ovary has been observed.
Despite the overall reassuring findings of the available studies, there is a need for well-designed clinical trials to understand the possible carcinogenic effects of the ovulation-inducing drugs.

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Available from: Tanja Pejovic
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    • "Ovarian-stimulation drugs have been widely used in infertility-treatment regimes for nearly 40 years. Limited studies, mainly case reports and retrospective studies, have investigated the safety of these drugs and the associated risks (Whittemore et al., 1992;Rossing et al., 1994;Mahdavi et al., 2006;Vlahos et al., 2010), and have reported that treatments may be associated with the increased risk of some specific cancers. However, most research into the long-term effects of ovarianstimulation medications on the risk of cancer have had their shortcomings as many cohort studies have short follow-up periods. "
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    • "Our previous studies confirmed these results (mean dysplasia score 7.64) and ovarian dysplasia seemed to be linked to the intensity and number of stimulations (dose-effect) and after a sufficient lapse of time (time-effect).13 However, the long term evolution is unknown.14,22 Animal experiments have given some interesting conclusions. "
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    • "Moreover, the risk of cancer has been shown to be similar in children conceived by artificial reproductive therapies and those conceived naturally [27]. It should also be noted that, due to close medical surveillance, malignancies are overdiagnosed in the female population; this may also augment the early detection of cancers [28]. "
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