Induction of ovulation and ovarian cancer: a critical review of the literature.
OBJECTIVE
To critically examine the possible association between ovulation-inducing drugs and ovarian cancer.


METHODS
Medline literature review and cross-reference of published data.


RESULTS
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.


CONCLUSIONS
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.
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York, USA. amahdavi@uci.edu
Ali
A
Mahdavi
Tanja
T
Pejovic
Farr
F
Nezhat
D005260:Female; D005299:Fertility Agents / Q000009:adverse effects*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D010062:Ovulation Induction / Q000009:adverse effects* / Q000706:statistics & numerical data; D012307:Risk Factors
D005299:Fertility Agents