In vitro fertilization, endometriosis, nulliparity and ovarian cancer risk

Stewart, Louise M., Holman, C. D'Arcy J., Aboagye-Sarfo, Patrick, Finn, Judith, Preen, David B. and Hart, Roger (2013) In vitro fertilization, endometriosis, nulliparity and ovarian cancer risk. Gynecologic Oncology, 128 2: 260-264. doi:10.1016/j.ygyno.2012.10.023


Author Stewart, Louise M.
Holman, C. D'Arcy J.
Aboagye-Sarfo, Patrick
Finn, Judith
Preen, David B.
Hart, Roger
Title In vitro fertilization, endometriosis, nulliparity and ovarian cancer risk
Journal name Gynecologic Oncology   Check publisher's open access policy
ISSN 0090-8258
1095-6859
Publication date 2013-02
Sub-type Article (original research)
DOI 10.1016/j.ygyno.2012.10.023
Open Access Status
Volume 128
Issue 2
Start page 260
End page 264
Total pages 5
Place of publication Maryland Heights, MO, United States
Publisher Academic Press
Language eng
Formatted abstract
Objectives: To examine the risk of invasive epithelial ovarian cancer in a cohort of women seeking treatment for infertility.

Methods: Using whole-population linked hospital and registry data, we conducted a cohort study of 21,646 women commencing hospital investigation and treatment for infertility in Western Australia in the years 1982–2002. We examined the effects of IVF treatment, endometriosis and parity on risk of ovarian cancer and explored potential confounding by tubal ligation, hysterectomy and unilateral oophorectomy/salpingo-oophorectomy (USO).

Results: Parous women undergoing IVF had no observable increase in the rate of ovarian cancer (hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.35–2.90); the HR in women who had IVF and remained nulliparous was 1.76 (95% CI 0.74–4.16). Women diagnosed with endometriosis who remained nulliparous had a three-fold increase in the rate of ovarian cancer (HR 3.11; 95% CI 1.13–8.57); the HR in parous women was 1.52 (95% CI 0.34–6.75). In separate analyses, women who had a USO without hysterectomy had a four-fold increase in the rate of ovarian cancer (HR 4.23; 95% CI 1.30–13.77). Hysterectomy with or without USO appeared protective.

Conclusions: There is no evidence of an increased risk of ovarian cancer following IVF in women who give birth. There is some uncertainty regarding the effect of IVF in women who remain nulliparous. Parous women diagnosed with endometriosis may have a slightly increased risk of ovarian cancer; nulliparous women have a marked increase in risk. 
Keyword In vitro fertilization
Ovarian cancer
Cohort study
Hazard ratios
Risk factors
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Tue, 15 Jul 2014, 10:03:26 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work