OVULATION INDUCTION AGENTS AND OVARIAN CANCER

  • Barbara Požlep Klinični oddelek za reprodukcijo Ginekološka klinika Klinični center Šlajmerjeva 3 1000 Ljubljana
  • Helena Meden Vrtovec Klinični oddelek za reprodukcijo Ginekološka klinika Klinični center Šlajmerjeva 3 1000 Ljubljana
Keywords: infertility, assisted reproductive technologies, ovulation induction agents, ovarian cancer

Abstract

Background. Ovarian cancer is the most frequent

cause of death among gynecologic malignancies. Epidemiological

data show that environmental, hormonal and genetic

factors are etiologically significant. Beside the already known

risk factors, ovulation induction agents have been reported as

risk factors in literature since 1986. Over the last two decades,

ovulation induction agents have been widely used in various

assisted reproduction techniques (ART). This study focused

on the question whether in patients receiving ovulation induction

agents the risk for developing pathologic processes on

the ovaries was higher than in those not receiving them, and

whether they were related to the dose and type of ovulation

induction agent.


Methods. In a prospective study 380 subjects were enrolled.

The study group consisted of 280 women who had undergone

an ART procedure three or more times. The control group consisted

of 120 infertile women, never included in an ART procedure.

All the enrolled subjects underwent the same examinations:

a detailed gynecological history was taken, pelvic examination

and vaginal ultrasound were performed, and a blood

sample for tumour marker CA 125 determination was taken.

Statistical analysis was done using Chi-square test, t test and

logistic regression.


Results. Ultrasound examination revealed pathology on the

genital tract in 136 women in the study group and in 60 women

in the control group. Differences in the incidence of ovarian,

tubal and uterine pathology were not statistically significant.

The analysis of the medical records showed that the incidence

of ovarian pathology was significantly higher in the

study than in the control group (p < 0.05). We found no correlation

between the incidence of ovarian pathology and type

or dose of ovulation induction agent. Increased CA 125 levels

were found in 12 women. In none of the women neither malignant

nor borderline malignant disease was found.


Conclusions. Although the analysis of the data from medical

history showed statistically higher incidence of ovarian pathology

in the study than in the control group, clinical, ultrasound

and biochemical examinations of the current health

status showed no difference between the groups. Also, no correlation

between ovarian pathology and type or dose of ovulation

induction agent was found. We believe that the risk of

ovarian malignancy due to ovulation induction agents is very

small. For definitive answers large prospective studies are required.

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Published
2017-04-13
How to Cite
1.
Požlep B, Meden Vrtovec H. OVULATION INDUCTION AGENTS AND OVARIAN CANCER. TEST ZdravVestn [Internet]. 13Apr.2017 [cited 5Aug.2024];70(10). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/2552
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Original article