Risk of ovarian cancer in women using ovarian induction protocols for infertility treatment.

Research Article


Abstract views: 87 / PDF downloads: 32

Authors

  • Elmahaishi MS

DOI:

https://doi.org/10.58372/2835-6276.1126

Keywords:

Subfertility, Fertility drugs, ovarian cancer, intracytoplasmic sperm injection

Abstract

Abstract: Cancer is rapidly becoming a major cause of morbidity and mortality worldwide, & Infertility has been found to be an important risk factor for ovarian cancer. However, the association between infertility drugs and ovarian cancer needs to be addressed with consideration of other factors such as age, body mass index, parity, genetic factors (i.e. family history for ovarian cancer), and etiology of the infertility, along with longer followup times

Aim of the study:To rule out or to prove that; the ovulation induction in infertility treatments and can cause ovarian cancer .

Design: Retrospective randomized study

Setting: Data were obtained from the patient records of those who were diagnosed as ovarian problem, which indicate surgical intervention, at lamis hospital for infertility & Gyn. Misurata -libya. From January 1, 2017 to December 31, 2023.  (seven years). Our study contained 110 patients operated with ovarian tumors & 3608   patients treated for infertility by ovulation induction drugs & icsi .

Results: The age range of patients with ovarian tumors in our study was from 24 to 72 years, and the highest incidence of ovarian tumors  was seen between 46 to 60 years. Most of the patients were at postmenopaus. More than half of the patient with ovarian pathology (58.2%) were multiparous; while nulliparous & patients delivered up to three kids were 8.2% & 33.6% consecutively. The main complain that the patient with ovarian pathology presented with abnormal vaginal bleeding (38.2%) ,lower abdominal pain (26.4%), abnormal vaginal discharge (23.6%) & pelvic mass (21.8%), Some patients were with more than one complains. Only two patient out of 110  included at this study , received ovulation induction drugs (1.8%), while 98.2% of patient with ovarian pathology they never use any drugs for ovarian stimulation. Out of (110) patient there 38 patient were their diagnosis confirmed by histopathology as ovarian cancer of different types, tow patients were received ovulation induction drugs. Only one of them with history of icsi & ovum retrieval (1/3608) I.e. 0.027%, she also had family history of breast cancer.(3608 are the number of cases done ovum retrieval for icsi at lamis infertility clinic at the period from  January 2017 up to December 2023.)

Conclusions: Although ,the question of whether ovarian stimulation increases the incidence of ovarian cancer, as an independent factor remains unanswered , We confirmed that ovulation induction drugs as treatment of infertility & ovum retrieval for icsi  are not a risk factors for ovarian cancer, and we observed no increase incidence of ovarian cancer  , Further larger studies are recommended to confirm such findings

References

Abeer Hussein Amer , Lobna Abdalla Elfrgani Asma Saad Alwerfaly , Amira Salem Hussein , Zainab Abdel Aziz Almaghrbi , Mabrouka Hussein Ali and Wedad Azmi Saadi Histopathological analysis of ovarian cancer in Benghazi medical center (BMC) in Benghazi - Libya from the years 20202021 Open Access Research Journal of Life Sciences, 2023, 05(02), 001 009 Article DOI: https://doi.org/10.53022/oarjls.2023.5.2.0020

Abouzriq, G. A., Elfrgani, L. A., Mohamemmed, A. B., Al-Sinfaz, A. A., Muhammad, B. S., Basem, N. B., and Amer, A. H. (2023). Histopathological changes in female uterus with postmenopausal vaginal bleeding in Benghazi Medical Center (2019-2021). International Journal of Multidisciplinary Research and Analysis, 06(01).https://doi.org/10.47191/ijmra/v6-i1-26

Abdelhamid Attia, M.D. Evidence-based diagnosis: I. Diagnosis and probabilities Middle East Fertility Society Journal Vol. 11, No. 3, 2006

Adam, W., Gurashi, R. A., Humida, M. A., & Abdelaziz, F. G. (2017). Ovarian cancer in Sudan. Journal of Medical and Almisawi, M. M., & Albajalan, O. B. (2021). Risk Factors for Ovarian Cancer among Libyan Women. Indian Journal of Public Health Research & Development, 12(2)

Adewole IF, Babarinsa IA, Thomas JO, Ajayi AB Ovarian cancer associated with ovulation induction: a case report..Afr J Med Med Sci. 1997 SepDec;26(3-4):203-4.PMID: 10456173

Balasch J, Barri PN Follicular stimulation and ovarian cancer? Hum Reprod. 1993 Jul;8(7):990-6. doi: 10.1093/oxfordjournals.humrep.a138215.PMID: 8408506 Review. No abstract available.

Barry JA, Azizia MM, Hardiman PJ Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis..Hum Reprod Update. 2014 Sep-Oct;20(5):748-58. doi: 10.1093/humupd/dmu012. Epub 2014 Mar 30.PMID: 24688118.

Chang Liu 1, Guimei Feng 1 2, Wei Huang 1, Qiuyi Wang 1, Shiyuan Yang 1, Jing Tan 1, Jing Fu 1, Dong Liu 1 Comparison of clomiphene citrate and letrozole for ovulation induction in women with polycystic ovary syndrome: a prospective randomized trial Biological Science Research, 3(4), 37-41. PMID: 28557652 DOI: 10.1080/09513590.2017.1332174 . 2017 Nov;33(11):872-876. doi:10.1080/09513590.2017.1332174. Epub 2017 May 30

Cetin I, Cozzi V, Antonazzo Infertility as a cancer risk factor - a review.P.Placenta. 2008 Oct;29 Suppl B:169-77. doi: 10.1016/j.placenta.2008.08.007.PMID: 18790330 Review.

Cohen J, Forman R, Harlap S, Johannisson E, Lunenfeld B, de Mouzon J, Pepperell R, Tarlatzis B, Templeton A IFFS expert group report on the Whittemore study related to the risk of ovarian cancer associated with the use of infertility agents..Hum Reprod. 1993 Jul;8(7):996-9. doi: 10.1093/oxfordjournals.humrep.a138216.PMID: 8408507 No abstract available.

D Meirow 1, J G Schenker The link between female infertility and cancer: epidemiology and possible aetiologies Hum Reprod Update . 1996 Jan-Feb;2(1):63-75. doi: 10.1093/humupd/2.1.63. DOI: 10.1093/humupd/2.1.63

El Mistiri M, Verdecchia A, Rashid I, El Sahli N, El Mangush M, Federico M. Cancer incidence in eastern Libya: the first report from the Benghazi Cancer Registry, 2003. Int J Cancer. 2007;120:392–397. [PubMed] [Google Scholar]

El Mistiri M, Pirani M, El Sahli N, El Mangoush M, Attia A, Shembesh R, Habel S, El Homry F, Hamad S, Federico M. Cancer profile in Eastern Libya: incidence and mortality in the year 2004. Ann Oncol. 2010;21:1924– 1926. [PubMed] [Google Scholar]

Lerner-Geva L, Rabinovici J, Lunenfeld B Ovarian stimulation: is there a longterm risk for ovarian, breast and endometrial cancer?.Womens Health (Lond). 2010 Nov;6(6):831-9. doi: 10.2217/whe.10.67.PMID: 21118041 Review.

Land JA Ovulation, ovulation induction and ovarian carcinoma..Baillieres Clin Obstet Gynaecol. 1993 Jun;7(2):455-72. doi: 10.1016/s0950-3552(05)801403.PMID: 8358900 Review.

Mary Anne Rossing 1, Mei-Tzu C Tang, Elaine W Flagg, Linda K Weiss, Kristine G Wicklund A case-control study of ovarian cancer in relation to infertility and the use of ovulation-inducing drugs Am J Epidemiol. NATIONAL LIBRARY OF MEDICINE 2004 Dec 1;160(11):1070-8. doi: 10.1093/aje/kwh315. PMID: 15561986 DOI: 10.1093/aje/kwh315

Meczekalski B, Pérez-Roncero GR, López-Baena MT, Chedraui P, PérezLópez FR. The polycystic ovary syndrome and gynecological cancer risk. Gynecol Endocrinol. 2020 Apr;36(4):289-293. doi: 10.1080/09513590.2020.1730794. Epub 2020 Feb 27.PMID: 32103691 Review.

Melie NA, Adeniyi OA, Igbineweka OM, Ajayi RA (2003) Predictive value of the number of oocytes retrieved at ultrasound-directed follicular aspiration with regard to fertilization rates and pregnancy outcome in intracytoplasmic sperm injection treatment cycles. Fertil Steril 80: 1376–1379.

Mohamed Ahmed Maher 1Luteal phase support may improve pregnancy outcomes during intrauterine insemination cycles Eur J Obstet Gynecol Reprod Bio 2011 Jul;157(1):57-62. doi: 10.1016/j.ejogrb.2011.03.022. Epub 2011 Apr 21

Nasr-Esfahani MH, Deemeh MR, Tavalaee M (2010) Artificial oocyte activation and intracytoplasmic sperm injection. Fertil Steril 94: 520–526.

National Oncology Institute. First Annual Report: Population Based Cancer Registry. Sibratha: Sibratha Cancer Registry; 2008. Available from: http://www.ncisabratha.ly/nci/filesystem/uploads/REPORT1.pdf. [Googl e Scholar]

NICE 2013 Fertility problems: assessment and treatment Clinical guideline [CG156]Published: 20 February 2013 Last updated: 06 September 2017

Risch H A Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone J Natl Cancer Inst. 1998 Dec 2;90(23):1774-86. doi: 10.1093/jnci/90.23.1774.

Rizzuto I, Behrens RF, Smith LA Risk of ovarian cancer in women treated with ovarian stimulating drugs for infertility..Cochrane Database Syst Rev. 2019 Jun 18;6(6):CD008215. doi: 10.1002/14651858.CD008215.pub3.PMID: 31207666 Free PMC article.

Spritzer PM, Morsch DM, Wiltgen D [Polycystic ovary syndrome associated neoplasms]..Arq Bras Endocrinol Metabol. 2005 Oct;49(5):805-10. doi: 10.1590/s0004-27302005000500022. Epub 2006 Jan 23.PMID: 16444364 Review. Portuguese.

Whittemore AS Fertility drugs and risk of ovarian cancer. Hum Reprod. 1993 Jul;8(7):999-1000. doi: 10.1093/oxfordjournals.humrep.a138217.PMID: 8408508 No.

Wang S, Gaskins AJ, Farland LV, Zhang D, Birmann BM, Rich-Edwards JW, Wang YX, Tamimi RM, Missmer SA, Chavarro JE. A prospective cohort study of infertility and cancer incidence. Fertil Steril. 2023 Jul;120(1):134-142. doi: 10.1016/j.fertnstert.2023.02.028. Epub 2023 Feb 25.PMID: 36849034

Vanden Meerschaut F, Nikiforaki D, Heindryckx B, De Sutter P (2014) Assisted oocyte activation following ICSI fertilization failure. Reprod Biomed Online 28: 560–571.

Yassien, S., and Ahmed, S. (2019). Risk and Protective Factors Associated with Ovarian Cancer among Two Egyptian Cohorts. Evidence-Based Nursing Research, 1(2), 14.

Yu L, Sun J, Wang Q, Yu W, Wang A, Zhu S, Xu W, Wang X Ovulation induction drug and ovarian cancer: an updated systematic review and metaanalysis. .J Ovarian Res. 2023 Jan 24;16(1):22. doi: 10.1186/s13048-02201084-z.PMID: 36694251 Free PMC article. Review.

Zayyan, M. S., Ahmed, S. A., Oguntayo, A. O., Kolawole, A. O., & Olasinde, T. A. (2017). Epidemiology of ovarian cancers in Zaria, Northern Nigeria: a 10-year study. International Journal of Women's Health, 9, 855.

Zuhir Bodalal, Raouf Azzuz, and Riyad Bendardaf Cancers in Eastern Libya: First results from Benghazi Medical Center

Z. Wang Liu W, Ma J, Hou Y, Zhao J, Dong B, Tu S, Wang L, Guo Y. Share Elevated Serum Level of CA125 Is a Biomarker That Can Be Used to Alter Prognosis Determined by BRCA Mutation and Family History in Ovarian Cancer.Genet Test Mol Biomarkers. 2017 Sep;21(9):547-554. doi: 10.1089/gtmb.2017.0104. Epub 2017 Aug 11.PMID: 28799806

Gronwald J, Glass K, Rosen B, Karlan B, Tung N, Neuhausen SL, Moller P, Ainsworth P, Sun P, Narod SA, Lubinski J, Kotsopoulos J Treatment of infertility does not increase the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation. Hereditary Breast Cancer Clinical Study Group.Fertil Steril. 2016 Mar;105(3):781-785. doi: 10.1016/j.fertnstert.2015.11.034. Epub 2015 Dec 14.PMID: 26698676

Shapira M, Raanani H, Feldman B, Srebnik N, Dereck-Haim S, Manela D, Brenghausen M, Geva-Lerner L, Friedman E, Levi-Lahad E, Goldberg D, Perri T, Eldar-Geva T, Meirow D BRCA mutation carriers show normal ovarian response in in vitro fertilization cycles..Fertil Steril. 2015 Nov;104(5):1162-7. doi: 10.1016/j.fertnstert.2015.07.1162. Epub 2015 Aug 31.PMID: 26335130

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Published

2024-01-31

How to Cite

Elmahaishi MS. (2024). Risk of ovarian cancer in women using ovarian induction protocols for infertility treatment.: Research Article. American Journal of Medical and Clinical Research & Reviews, 3(1), 1–8. https://doi.org/10.58372/2835-6276.1126

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