A Cochrane review [Abstract] 2 included 13 case-control studies and 24 cohort studies with a total of4 684 724 women. Two cohort studies reported an increased incidence of invasive ovarian cancer in exposed subfertile women compared with unexposed women. The slight increase in ovarian cancer risk among women having between 1 and 3 cycles of in vitro fertilisation (IVF) was reported, but this was not clinically significant (P = 0.18). There was no increase in risk of invasive ovarian cancer after use of infertility drugs in women with the BRCA mutation according to one cohort and one case-control study.
Another Cochrane review [Abstract] 1 included 19 observational studies with a total of 1 937 880 participants. Overall, the quality of evidence was very low. Subfertile women with exposure to any ovary-stimulating drug did not have an increased risk of endometrial cancer compared with subfertile women without the exposure T1. An increased risk was found after exposure to any ovary-stimulating drug compared with general population without an exposure T1.
| Outcome in all: Endometrial cancer Treatment and comparison | Relative effect RR (95% CI) | Risk with no treatment | Risk with intervention (95% CI) | №of participants(studies) |
|---|---|---|---|---|
| Any ovary-stimulating drug for subfertilityComparison: Untreated subfertile women | RR 0.96(0.67 to 1.37) | 111 per 100 000 | 109 per 100,000(74 to 163) | 156 774(6) |
| Any ovary-stimulating drug for subfertilityComparison: General population | RR 1.75(1.18 to 2.61) | 53 per 100 000 | 92 per 100 000(62 to 138) | 1 762 829(15) |
| Clomiphene citrate for subfertilityComparison: Untreated subfertile women | RR 1.32(1.01 to 1.71) | 524 per 100 000 | 691 per 100 000(530 to 894) | 92 849(5) |
| Clomiphene citrate for subfertilityComparison: General population | RR 1.87(1.00 to 3.48) | 284 per 100 000 | 529 per 100 000(284 to 980) | 19 614(4) |
| Gonadotropins for subfertilityComparison: Untreated subfertile women | RR 1.55(1.03 to 2.34) | 1291 per 100 000 | 1987 per 100 000(1329 to 2970) | 17 769(4) |
| Gonadotropins for subfertilityComparison: General population | RR 2.12(0.79 to 5.64) | 542 per 100 000 | 1148 per 100 000(428 to 3054) | 1 595(2) |
| Clomiphene citrate and gonadotropins for subfertilityComparison: Untreated subfertile women | RR 1.18(0.57 to 2.44) | 490 per 100 000 | 579 per 100 000(279 to 1196) | 6 345(2) |
| Clomiphene citrate and gonadotropins for subfertilityComparison: General population | RR 2.99(1.53 to 5.86) | 76 per 100 000 | 245 per 100 000(150 to 401) | 7 789(3) |
| GnRH analogues for subfertilityComparison: Untreated subfertile women | RR 1.21(0.65 to 2.27) | 458 per 100 000 | 554 per 100 000(297 to 1039) | 42 558(2) |
Comment: The quality of evidence is downgraded by study quality.
Primary/Secondary Keywords