| Methods |
'Retrospective cohort'. All women who gave birth in 1974 to 1976 at 3 major obstetrical units in Israel and included in the Jerusalem Perinatal cohort study were linked with the Israel Population Registry and the Israel Cancer Registry |
| Participants |
N = 15,426; mean age 27.5 for exposed and NR for unexposed |
| Interventions |
Fertility treatment, dosage, and number of cycles were not reported. Clomiphene citrate (N = 312), human menopausal gonadotrophins (N = 61), other (N = 54), and unknown (N = 87). Follow‐up by exposure group was not reported |
| Outcomes |
Ovarian cancer by histological diagnosis (see Table 3) |
| Notes |
424,193 person‐years follow‐up (median 29 years) |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Selection bias |
Low risk |
All women in a given area with no history of ovarian cancer at the beginning of the study and with at least 1 ovary |
| Confounding |
Unclear risk |
Analysis adjusted for age at first birth, geographical origin, social class, education, parity, mean body mass index, time to conception, ovulation disorders, and mechanical treatment |
| Performance bias |
High risk |
Questionnaires; no blinding of assessors to case‐control status reported |
| Detection bias |
High risk |
Cancer registry; no blinding of assessors to exposure status used |
| Attrition bias |
Low risk |
HR was estimated and missing data were censored (8%) |
| Selective reporting (reporting bias) |
Unclear risk |
Unclear if all investigated fertility drugs were reported |
