Krebsrisiko nach ovarieller Stimulation

Background: With the increased utilization of assisted reproductive techniques both the scientific community as well as the lay public have focused their interest on adverse events and risks caused by ovarian stimulation and ovulation induction. Especially the postulated increased risk for gynecological cancers has elicited an ongoing controversy.

Aim: This article presents a summary, discussion and assessment of the available data in order to evaluate whether ovarian stimulation is accompanied by a higher risk of gynecological cancer.

Material and methods: A narrative review, summary and analysis of published cohort and case control studies, expert opinions and Cochrane Database publications related to ovarian stimulation and the incidence of gynecological malignancies are presented.

Results: It is still controversial whether ovarian stimulation is accompanied by a higher risk of cancer and a definitive answer cannot be given to the question. Current data suggest sterility as an independent risk factor for developing endometrial and ovarian cancer, whereas infertility treatment does not apparently lead to a significantly higher risk. The incidence of borderline ovarian tumors seems to be slightly higher for infertile patients. Study results on the supposed possible increased risk for breast cancer are very heterogeneous. For the time being a higher incidence of breast cancer has not unequivocally been demonstrated.

Conclusion: Further epidemiological investigations taking individual risk factors (risk confounders) into account are needed. Furthermore, the results of longer follow-up periods of ongoing studies must be awaited to draw robust conclusions, especially bearing the late age peak of some gynecological cancers in mind.