Fertility drug use and the risk of ovarian tumors in infertile women: a case-control study

Abstract

Objective To assess the influence of infertility and fertility drugs on risk of ovarian tumors. Design Case-control study (Mayo Clinic Ovarian Cancer Study). Setting Ongoing academic study of ovarian cancer. Patient(s) A total of 1900 women (1028 with ovarian tumors and 872 controls, frequency matched on age and region of residence) who had provided complete information in a self-report questionnaire about history of infertility and fertility drug use. Intervention(s) None Main outcome measure(s) Effect of infertility history, use of fertility drugs and oral contraception and gravidity on the risk of ovarian tumor development, after controlling for potential confounders. Result(s) Among women who had a history of infertility, use of fertility drugs was reported by 24% (44/182) of controls and 17% (38/226) of cases. Infertile women who used fertility drugs were not at increased risk of developing ovarian tumors compared to infertile women who did not use fertility drugs, adjusted odds ratio was 0.64 (95% CI 0.37, 1.11). Findings were similar when stratified by gravidity and when analyzed separately for borderline versus invasive tumors. Conclusion(s) We did not find any significant association between fertility drug use and risk of ovarian tumors. Further larger, prospective studies are needed to confirm this observation.

Cancer Risk in Women Treated with Fertility Drugs According to Parity Status—A Registry-based Cohort Study

“…In our previous study, we found higher risk of ovarian cancer in women with primary infertility and those conceiving only one child (23). On the other hand, several other studies observe no increase in risk of ovarian cancers (39–41), and/or no difference in risk between nulliparous and parous women with fertility treatment (20, 41). …”

Epithelial ovarian tumors and fertility drugs—are we asking the right questions?

“…This would seem to be a particular concern for women who are not anovulatory, as the stimulation would occur against a backdrop of incessant ovulation. In the current article (1), neither infertility nor infertility drug use were associated with increased risk of ovarian tumor. Whereas statistical power was modest, the study had the power to detect an effect for infertility and infertility drug use well below a risk of 2.0, which is in range of several previous reports.…”

“…The article by Dr. Asante and colleagues (1) in the current issue attempts to address the question whether or not infertility drugs increase ovarian tumor risk. This is a question of great interest to the reproductive health community—but it is not a simple question and the data to provide a clear answer appear elusive.…”

Use of fertility drugs and risk of ovarian cancer

“…Results from two recent case-control studies conducted in the United States provide further evidence that fertility drug use does not significantly contribute to risk of ovarian cancer among the majority of women when adjusting for known confounding factors [48*,49*]. Both studies observed no association between fertility drug use and overall risk of ovarian cancer.…”

“…Both studies observed no association between fertility drug use and overall risk of ovarian cancer. Kurta et al used data from the Hormones and Ovarian Cancer Prediction (HOPE) study [48*]; Asante et al used data from the Mayo Clinic Ovarian Cancer study [49*]. Strengths of both studies include a relatively large sample size and the availability of detailed reproductive and medical histories of study participants.…”