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Table 1 Fertility drugs and ovarian cancer (Cohort studies)

From: Fertility drugs, reproductive strategies and ovarian cancer risk

Study Treatments Population Results
Rossing et al.[21] 1994 Clomiphene citrate 3837 women, 9 ovarian cancer in exposed, 2 ovarian cancer in unexposed ≥ 12 cycles with clomiphene citrate associated with RR = 11.1 (95% CI: 1.5-82.3) compared to the general population
Potashnik et al.[25] 1999 Definited as use of fertility drugs 1197 women. 1 ovarian cancer in exposed; 1 ovarian cancers in unexposed SIR in exposed = 0.68 (95% CI: 0.01-3.80). SIR in unexposed = 1.35 (95% CI: 0.02-7.49).
Doyle et al.[23] 2002 Clomiphene citrate, hMG, hCG, GnRH analog, 4188 women, 4 ovarian cancers in exposed, 2 ovarian cancers in unexposed SIR in exposed = 0.84 (95% CI: 0.23-2.15). SIR in unexposed = 1.67 (95% CI: 0.20-6.05). RR exposed vs unexposed = 0.59 (95% CI: 0,12-3,00)
Brinton et al.[26] 2004 Clomiphene citrate or gonadotropins 12193 infertile women, 15 ovarian cancers in exposed, 30 cancers in unexponed RR exposed vs unexposed = 0.82 (95% CI: 0.4-1.5)
Calderon- Margalit et al.[24] 2009 Self reported exposure to fertility drugs 15030 parous women. Only 1 cancer in exposed 42 cancers in unexposed No association found between fertility drugs and ovarian cancer (age-adjusted HR = 0.61). Only parous women
Jensen et al.[28] 2009 hMG, FSH, Clomiphene citrate, hCG, GnRH-analog, 54362 women, 156 ovarian cancers, 58 ovarian cancers in exposed, 98 cancers in unexponed No risk increase associated with hMG, FSH, hCG, GnRH-analog. RR exposed vs unexposed for Clomiphene citrate: 1.14 (95% CI: 0.79- 1.64)
Dos Santos Silva et al.[29] 2009 Definited as use of fertility drugs 7355 women 12 cancers in exposed, 8 cancers in unexposed SIR in exposed =1.10 (95% CI: 0,57-1.93) SIR in unexposed =0,78 (95% CI: 0.34-1.53) RR exposed vs unexposed =1,42 (95% CI: 0,53-3.99)
Sanner et al.[22] 2009 Clomiphene citrate and/or gonadotropins 2768 women, 16 cancers in exposed (9 ovarian cancers, 7 borderline tumors); 13 cancers in unexposed SIR = 5.89 for ovarian cancer (95% CI: 1.91-13.75) SIR = 3.61 for borderline tumors (95% CI: 1.45-7.44). RR = 5.28 (95% CI: 1.70-16.47) for invasive cancers associated with gonadotropins
Lerner- Geva et al.[35] 2012 Gonadotropins 2431 women, 18 ovarian cancer cases, 30 years of follow-up SIR = 1.0 (95% CI: 0.59-1.57)
Trabert et al.[27] 2013 Clomiphene citrate, with or without gonadotropins 9825 women, 85 ovarian cancers RR for clomiphene citrate = 1.34 (95% CI: 0.86-2.07) RR for gonadotropins = 1.00 (95% CI: 0.48-2.08)
  1. Abbreviations: RR = relative risk, CI = confidence interval, SIR = standardized index ratio, hMG = human menopausal gonadotropin, hCG = human chorionic gonadotropin, GnRH = gonadotropin releasing hormone, HR = hazard ratio, FSH = follicle stimulating hormone.