Table 3.
Characteristics of studies linking infertility to ovarian cancer
| Study | Location | Study type | Year | Cases (n) | Study-specific population | Findings in female subjects |
|---|---|---|---|---|---|---|
| Venn et al. (1995) [10] | Australia | Retrospective cohort | 1995 | 10,358 | Women undergoing IVF Stimulated IVF (n = 5564) Natural IVF (n = 4794) |
No significant difference in ovarian cancer rates compared to general population Stim IVF: SIR 1.70 (95% CI 0.55–5.27) Nat IVF: SIR 1.62 (95% CI 0.52–5.02) Women w/unexplained infertility had higher ovarian CA risk: RR 19.19 (95% CI 2.23–165) |
| Reigstad et al. [15] | Norway | Retrospective cohort | 2015 | 16,525 | Women who gave birth after undergoing ART | No significant elevation in overall ovarian CA risk: HR 1.56 (95% CI 0.94–2.60) Women w/1 delivery: HR for ovarian CA slightly elevated (HR 2.00, 95% CI 1.08–3.65) |
| Cirillo et al. [18] | USA | Prospective cohort | 2016 | 15,528 mothers 116 (0.75%) w/ovarian CA |
Irregular menses by self report and medical record in women with and without ovarian CA | Women w/irregular menses had a 2-fold increased risk of ovarian CA in incidence and mortality by age 70 over 50-year follow up. 95% CI 1.1–3.4 |
| Barry et al. [8] | UK | Systematic review Meta-analysis |
2014 | 11 studies (919 women with PCOS) |
Diagnosis of PCOS | Risk of ovarian CA in women w/PCOS was not significantly increased (OR 1.41, 95% CI 0.93–2.15) In studies w/younger women (<54 yo), ovarian CA risk was elevated for PCOS women (OR 2.52, 95% CI 1.08–5.89) |
| Venn et al. (1999) [7] | Australia | Retrospective cohort | 1999 | 29,700 | Women undergoing IVF Stimulated IVF (n = 20,656) Natural IVF (n = 9044) |
Ovarian cancer incidence was no greater than expected in either IVF group Stimulated: SIR 0.88 (95% CI 0.42–1.84) Natural: SIR 1.16 (95% CI 0.52–2.59) |
| Kvaskoff et al. [16] | USA, France, Sweden | Meta-analysis | 2015 | 21 publications | Women with endometriosis | 20 studies reported positive associations between endometriosis and ovarian CA. 1 study showed no association. |
| Luke et al. [17] | USA | Longitudinal cohort | 2015 | 113,226 | Women treated with ART 2004–2009 | Women treated with ART had a non-statistically significant higher risk of ovarian CA. Essentially no difference. (SIR 0.96–1.18) |
| Bjornholt et al. [19] | Denmark | Retrospective case-cohort | 2015 | 96,545 | Danish women who had been treated in fertility clinics 1963–2006 | Overall risk of borderline ovarian tumors not associated w/fertility drugs (RR 1.0, 95% CI 0.67–1.51) Use of progesterone increased risk of borderline serous ovarian tumors (RR 1.82, 95% CI 1.03–3.24) |
| Rizzuto et al. [20] | UK | Systematic review | 2013 | 11 case-control 14 cohort n = 182,972 |
Women with exposure to ovarian stimulating drugs for treatment of infertility. Borderline or invasive ovarian CA |
7 cohort studies showed no elevation in risk of invasive ovarian CA. 7 case-control studies showed no increased risk of invasive ovarian CA. 2 cohort studies showed increased risk of invasive ovarian CA. 2 case-control studies showed 2–3 fold increase in borderline ovarian CA risk Overall, no increased risk of invasive ovarian CA; possible increased borderline tumor risk |
SIR standardized incidence ratio