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Ovarian stimulation and borderline ovarian tumors: a case-control study
B J Mosgaard1, O Lidegaard, S K Kjaer
1University of Copenhagen, and Institute of Cancer Epidemiology, Danish Cancer Society.
Fertility and Sterility
|December 16, 1998
Summary
Infertile nulliparous women face a doubled risk of borderline ovarian cancer, even without fertility drug treatment. Fertility drugs did not significantly alter this risk in nulliparous or parous women.
Area of Science:
- Reproductive medicine
- Gynecologic oncology
- Epidemiology
Background:
- Infertility affects a significant portion of women seeking reproductive assistance.
- Fertility treatments are commonly used to address infertility.
- Ovarian cancer risk factors are multifactorial, including reproductive history.
Purpose of the Study:
- To investigate the association between infertility, fertility drug use, and the risk of borderline ovarian cancer.
- To determine if parity influences the risk of borderline ovarian cancer in infertile women.
- To assess the specific risk conferred by fertility treatments in the context of infertility and parity.
Main Methods:
- A nationwide case-control study was conducted using Danish public registers and postal questionnaires.
- The study included 231 women diagnosed with borderline ovarian cancer and 1,721 randomly selected population controls, all under 60 years old.
- Multivariate analysis controlled for potential confounders including parity and infertility status.
Main Results:
- Infertile nulliparous women without fertility treatment had an approximately twofold increased odds ratio (OR) for borderline ovarian cancer compared to fertile nulliparous women (OR = 1.9).
- Among nulliparous women, fertility drug treatment was associated with a 1.5-fold increased OR for borderline ovarian cancer compared to untreated infertile women (OR = 1.5).
- Among parous women, fertility drug treatment was also associated with a 1.5-fold increased OR compared to untreated infertile parous women (OR = 1.5).
Conclusions:
- Infertility, particularly in nulliparous women, is associated with an elevated risk of borderline ovarian cancer.
- Fertility drug treatments did not demonstrate a statistically significant increase in borderline ovarian cancer risk compared to untreated infertile women, regardless of parity.
- The findings suggest that infertility itself, rather than fertility drug use, may be a more significant factor in the increased risk of borderline ovarian cancer observed in this population.