Ovulation-inducing drugs and ovarian cancer risk: results from an extended follow-up of a large United States infertility cohort.

Abstract:

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 = 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.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Trabert B,Lamb EJ,Scoccia B,Moghissi KS,Westhoff CL,Niwa S,Brinton LA

doi

10.1016/j.fertnstert.2013.08.008

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

1660-6

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(13)02953-1

journal_volume

100

pub_type

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