TY - JOUR
T1 - Epithelial ovarian cancer, infertility and induction of ovulation
T2 - Possible pathogenesis and updated concepts
AU - Goshen, R.
AU - Weissman, A.
AU - Shoham, Z.
N1 - Funding Information:
epithelial ovarian cancer were more likely to have a history of previous exposure to fertility drugs than healthy subjects. They found that the risk of ovarian cancer was increased in women who had used human menopausal gonadotropin (hMG) (odds ratio (OR) 1.97, 95% CI 1.03-3.77), and the risk was particularly increased in the subgroup of women with borderline ovarian tumours who had used hMG (OR 14.58, 95% CI 3.82-55.91). These studies probably reflect the important data relating induction of ovulation to increased risk of ovarian cancer. In contrast to the above-mentioned association and as already mentioned, some relatively early studies pointed to the lack of tumorigenesis associated with induction of ovulation. For example, Ron et al (1987) found no difference between infertile treated and non-treated women. Venn et al (1995) failed to find an association between fertility drugs and ovarian cancer among in vitro fertilization (IVF) patients. This notion was again attributed to the small sample size (5564 patients in the study arm) and the low prevalence of ovarian cancer. Two additional case-control European studies were published during the last year documenting no increase in ovarian cancer due to fertility treatment, further contributing to the controversy (Mosgaard et al, 1997; Parazzini et al, 1997). Vlahos (1998) observed that treating infertile nulliparous patients with fertility drugs ends in successful pregnancy in a considerable percentage of these patients, thus possibly reducing their risk of ovarian cancer. It is therefore clear that a co-operative initiative should be undertaken in an effort to recruit enough patients for statistically meaningful conclusions to be drawn. Major support is to be expected from National Institutes of Health (NIH) granted projects, mainly through the National Cancer Institute (NCI) and National Institute of Child Health and Human Development (NICHD). Dr M. A. Rossing from Seattle, Washington, is currently expanding her previous study and has been nominated as the principal investigator in two of these NIH grants. It is hoped that more conclusive data will be obtained on completion of these studies.
PY - 1998
Y1 - 1998
N2 - Numerous case-control, cohort studies, case reports and reviews have been published during the last 5 years regarding the association between infertility and induction of ovulation and epithelial ovarian cancer. Despite this amount of published material, final conclusions regarding direct linkage between these different aspects of infertility and ovarian cancer, as well as any data relating to a putative pathogenetic mechanism, cannot be drawn. In this review we summarize the available data as well as update a previous review by Shoham published in 1994. We outline some of the information that has become available from basic research which may help to direct investigators to suitable clinical research models that may eventually serve to clarify this enigma. Finally we share ideas that focus on specific high-risk cohorts.
AB - Numerous case-control, cohort studies, case reports and reviews have been published during the last 5 years regarding the association between infertility and induction of ovulation and epithelial ovarian cancer. Despite this amount of published material, final conclusions regarding direct linkage between these different aspects of infertility and ovarian cancer, as well as any data relating to a putative pathogenetic mechanism, cannot be drawn. In this review we summarize the available data as well as update a previous review by Shoham published in 1994. We outline some of the information that has become available from basic research which may help to direct investigators to suitable clinical research models that may eventually serve to clarify this enigma. Finally we share ideas that focus on specific high-risk cohorts.
KW - Infertility
KW - Ovarian carcinoma
KW - Ovulation induction
UR - http://www.scopus.com/inward/record.url?scp=0031722935&partnerID=8YFLogxK
U2 - 10.1016/S0950-3552(98)80053-9
DO - 10.1016/S0950-3552(98)80053-9
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C2 - 10627769
AN - SCOPUS:0031722935
SN - 0950-3552
VL - 12
SP - 581
EP - 591
JO - Bailliere's Clinical Obstetrics and Gynaecology
JF - Bailliere's Clinical Obstetrics and Gynaecology
IS - 4
ER -
