Introduction: introduction
Infertility is a global concern, and the utilization of assisted reproductive technology (ART) is currently a common solution to tackle it.The administration of strong hormonal drugs has raised concerns about the potential risk of hormone-dependent malignancies, including ovarian, breast, and endometrial cancers.A notable challenge in this field is differentiating the risk associated with ART from the risk related to the underlying cause of infertility, as infertility is acknowledged as an independent risk factor for various malignancies. A thorough analysis of the scientific evidence is crucial to determine the true relationship between ART and cancer risk .
The objective of this review is to conduct a detailed and comprehensive examination of the existing scientific evidence to ascertain the genuine correlation between ART and cancer risk.
Methods: We performed an exhaustive search of the scientific databases PubMed, Scopus, and Web of Science. Search phrases encompassed several combinations of terms of infertility ("ART," "IVF," "Infertility") and disease ("Cancer," "Neoplasm," "Ovarian Cancer," "Breast Cancer," "Endometrial Cancer"). Large observational cohort studies and pertinent meta-analyses were chosen for examination.
Results: The findings of this research indicate that there is insufficient evidence to support a substantial correlation between ART and an elevated risk of breast cancer. Research on endometrial cancer presents mixed results; some research indicates a dose-dependent increase in risk associated with clomiphene citrate, while others fail to corroborate this link. The findings regarding ovarian cancer are more intricate.
Recent studies have not shown a definitive correlation between IVF treatment and an elevated risk of invasive ovarian cancer.
Conclusion: Conclusion
Our findings indicate that women who have undergone ART treatments and given birth exhibit a heightened risk of ovarian cancer and borderline ovarian tumors (BOT). Comparing the ART group with untreated infertile women reduced the elevated risk, underscoring the significant impact of infertility as a confounding variable. Nonetheless, due to the variability in causes and severity of infertility among different groups, it is not feasible to conclusively determine if ART directly leads to cancer development. Despite extensive research over several decades, there is insufficient evidence to establish a causal association between ART therapies and an elevated risk of prevalent invasive malignancies. This discovery has significant practical ramifications, enabling clinicians to more assuredly inform their patients that ART does not substantially elevate the risk of invasive malignancies. To elucidate this association comprehensively, subsequent research must concentrate on bigger cohort studies with extended follow-up, while meticulously gathering and analyzing data on treatment regimens and confounding variables.Ultimately, any heightened risk must be evaluated against the comparatively low incidence of ovarian cancer within the general population.
Keywords: Infertility, ART, Ovarian Cancer, Breast Cancer, Endometrial Cancer