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Fertility
Drugs and Their Relationship to Cancer
Media coverage of an article by
Dr. Alice Whittemore of the Stanford University Ovarian
Cancer Collaborative Group which appeared in the American
Journal of Epidemiology several years ago has created
some anxiety amongst patients who have taken fertility
medications. To help patients understand how this
may relate to themselves, HRC has researched this issue.
In the Stanford report, three of
the 12 studies contained women who remembered taking
fertility drugs.
Out of the 2,197 ovarian cancer patient histories reviewed,
31 patients remembered taking fertility
drugs. However, it is not known what kind of medication
the women took, for how long or in what dosages. Stanford's
news release itself stressed this fact: "The drugs
were given before the 1970s, so they were probably given
for routine pregnancy as opposed to use for in vitro
fertilization. The association between ovarian cancer
and fertility drugs was seen principally in those who
never became pregnant, suggesting that possibly the
type of infertility rather than the drug use itself
may be associated with risk (of ovarian cancer)".
The National Institute of
Health (NIH) recently recommended only selective ovarian
cancer screening in women. They stated that annual ovarian
cancer screening is justifiable only for a small well-defined
segment of the population, those being women who have
two second-degree relatives or one first and one second
degree relative who have had ovarian cancer. The NIH,
however, did not specifically look at the issue of women
who have fertility medications and they suggest more
studies are needed in this subgroup.
Notwithstanding the above, as a
precautionary measure, HRC recommends that its patients
and others who have had treatments with fertility drugs
should have ovarian cancer screening performed once
a year in much the same way as they have routine Pap
tests done. Ovarian cancer screening includes pelvic
examination, transvaginal ultrasonography,
and possible measurement of serum levels of the tumor
marker CA-125.
Studies have shown that several
treatments and factors can reduce the risk of ovarian
cancer. For example, pregnancy has been shown to reduce
the risk of developing this disease by 40%. Recent studies
suggest that tubal ligation, hysterectomy, and prophylactic
oophorectomy after completing child bearing for women
of high risk (such as those who have relatives who have
had ovarian cancer ) may also reduce the risk of developing
this disease. Multiple studies have demonstrated a 40-50%
decrease in ovarian cancer in women who use oral contraceptives.
Many medications are available to
treat infertility. Please select the links below for
more information:
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