Female infertility, infertility-associated diagnoses, and comorbidities: a review.
OBJECTIVE
The purpose of the study is to evaluate existing literature for possible associations between female infertility, infertility-associated diagnoses, and the following areas of disease: psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction.


METHODS
The design of the study is a literature review. The patients were women included in 26 selected studies due to a diagnosis of infertility or a reproductive disorder associated with infertility. This study has no interventions, and the main outcome measure is the association between female infertility or a related diagnosis and psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction.


RESULTS
Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1-10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7, 8, 10-20]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardiovascular disease and metabolic disorders such as diabetes than the general population [16, 21-26].


CONCLUSIONS
Female infertility and associated diagnoses have overall health implications. Beyond treatment of patients' immediate reproductive needs, healthcare professionals must be aware of the broader health impact of specific causes of infertility in order to provide accurate counseling regarding long-term risk.
Department of Obstetrics and Gynecology, University of Utah, 50 N Medical Drive, Salt Lake City, UT, 84132, USA. brent.hanson@hsc.utah.edu.
Brent
http://orcid.org/0000-0001-9671-2843
B
Hanson
Department of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, UT, USA.|Utah Center for Reproductive Medicine, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA.
Erica
E
Johnstone
Department of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, UT, USA.|Utah Center for Reproductive Medicine, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA.
Jessie
J
Dorais
Department of Obstetrics and Gynecology, University of Utah, 50 N Medical Drive, Salt Lake City, UT, 84132, USA.
Bob
B
Silver
Department of Reproductive Endocrinology and Infertility, University of Utah, Salt Lake City, UT, USA.|Utah Center for Reproductive Medicine, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA.
C Matthew
CM
Peterson
Department of Surgery - Urology, University of Utah Center for Reconstructive Urology and Men's Health, 675 Arapeen Way, Suite 205, Salt Lake City, UT, 84108, USA.
James
J
Hotaling
D000328:Adult; D015897:Comorbidity; D005260:Female; D005307:Fertilization in Vitro; D005833:Genital Neoplasms, Female / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D012098:Reproduction / Q000502:physiology
Fertility drugs; In vitro fertilization; Infertility; Malignancy; Somatic health