Reactions 623 - 19 Oct 1996

Ovulation induction does notnecessarily cause ovarian cancerAn association between ovulation induction and

ovarian cancer does not necessarily mean a causaleffect, say Drs Robert Bristow and Beth Karlan from theUS, after reviewing published literature.

The researchers conducted a Medline search of allcase reports, epidemiological studies and clinicalinvestigations relevant to the proposed associationbetween ovulation induction, infertility and an increasedrisk of ovarian cancer. They identified 4 case-controlstudies, 3 retrospective cohort studies and a large meta-analysis of 3 more case-control studies as being themost pertinent.

From the published data, no statistically significantincreased risk of developing ovarian cancer in infertilewomen receiving fertility treatment could bedemonstrated. The study authors noted that therelatively low incidence of ovarian cancer and multipleconfounding factors made the association difficult toassess. The small number of cases, variable treatmentregimens and duration of treatment, have made itdifficult to implicate specific fertility agents. However,several studies have shown that nulliparous womenwith refractory infertility may have an increased risk ofdeveloping any ovarian tumour, irrespective of their useof fertility drugs, compared with the general population.Therefore, there may be an association between fertilitydrugs and ovarian cancer simply because these womenare likely to have used ovarian stimulation during theirinfertility treatment.

Drs Bristow and Karlan conclude that largeprospective studies are necessary to address this issue.In the meantime, they suggest that careful clinicalevaluation be used both during and after medicaltreatment of infertility.Bristow RE, et al. Ovulation induction, infertility, and ovarian cancer risk. Fertilityand Sterility 66: 499-507, Oct 1996 800475206

1

Reactions 19 Oct 1996 No. 6230114-9954/10/0623-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved