Human menopausal gonadotropin and the risk of epithelial ovarian cancer

A. Shushan*, O. Paltiel, J. Iscovich, U. Elchalal, T. Peretz, J. G. Schenker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

226 Scopus citations

Abstract

Objective: To determine whether women with epithelial ovarian cancer are more likely to have been exposed to fertility drugs, and in particular hMG, than healthy population controls. Design: A nationwide case-control study. Patients: Two hundred living women 36 to 64 years of age, with a histologically confirmed diagnosis of primary invasive or borderline epithelial ovarian cancer that was first diagnosed and reported to the Israel Cancer Registry between January 1, 1990 and September 1, 1993 were enrolled. There were 164 (82%) invasive and 36 (18%) borderline epithelial ovarian tumors among the 200 cases. The controls were 408 women from the same dialing areas selected by random digit dialing. Cases and controls were interviewed using a standard questionnaire. A multivariate logistic model was used to assess the association of fertility drug use and ovarian cancer, controlling for variables found to be statistically associated with this outcome on univariate analysis. Results: Twenty-four women with epithelial ovarian cancer (12%) and 29 healthy controls (7.1%) reported that they had used any fertility drug (adjusted odds ratio [OR] 1.31; 95% confidence interval [CI] 0.63 to 2.74). Among cases and controls, respectively, 22 and 24 reported that they had used hMG alone or in combination with clomiphene citrate (adjusted OR 1.42, 95% CI 0.65 to 3.12), and 11 and 6 reported that they had used hMG alone (adjusted OR 3.19, 95% CI 0.86 to 11.82). The risk was increased particularly in the subgroup of women with borderline ovarian tumors who had used hMG (adjusted OR 9.38, 95% CI 1.66 to 52.08). Conclusions: We conclude that the use of ovulation induction agents, in particular hMG, may increase the risk of epithelial ovarian tumors.

Original languageAmerican English
Pages (from-to)13-18
Number of pages6
JournalFertility and Sterility
Volume65
Issue number1
DOIs
StatePublished - 1996
Externally publishedYes

Bibliographical note

Funding Information:
Received March 13, 1995; revised and accepted July 14, 1995. * Supported in part by a grant from the Joint Research Fund of the Hebrew University and Hadassah Medical Center, Jerusalem, Israel. t Department of Obstetrics and Gynecology, Hebrew University, Hadassah Ein-Karem Medical Center. t Reprint requests: Asher Shushan, M.D., Department of Obstetrics and Gynecology, Hadassah Medical Center, Kiryat Hadassah, P.O. Box 12000, IL 91120, Jerusalem, Israel (FAX: 972-2-432445). § Department of Social Medicine, Hebrew University, Hadassah Ein-Karem Medical Center. II Department of Epidemiology, Israel Cancer Registry, Ministry of Health.

Keywords

  • Ovulation induction
  • borderline ovarian tumors
  • gonadotropin
  • infertility
  • ovarian cancer

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